Amenorrhoea
Amenorrhoea means the absence of periods, and it may be primary (where the woman has never had a period) or secondary, occurring after a period of normal menstruation. Very rarely primary amenorrhoea occurs as a result of an imperforate hymen: the menstrual blood is retained in the vagina and uterus, causing abdominal swelling (called haemato-colpos). Other causes include resistant ovary syndrome, when other secondary sexual characteristics such as breast development and the presence of pubic hair are normal, or cases of delayed puberty.
Secondary amenorrhoea may be defined as absence of periods for six months in a woman who previously menstruated regularly. There are many causes, and the one that must always be excluded is pregnancy. Stress, overwork and anxiety can all affect the menstrual cycle, as can any disorder of pituitary function, thyroid over activity or ovarian disease such as polycystic ovary syndrome. It is a feature of anorexia nervosa (described in the brain and behaviour section). Secondary amenorrhoea may follow a period of oral contraceptive use, when it is called "post-pill amenorrhoea". Ultrasound examination of the ovaries shows that there are no developing follicles, and the ovaries may be thought to have gone to sleep. Ovulation can be stimulated using the drug clomiphene.
|
