AMENORRHEA, SECONDARY |
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DESCRIPTIONSecondary amenorrhea means the cessation of menstruation for at least 3 months in a female who has previously menstruated. The condition occurs only in females from puberty to menopause. The endocrine and reproductive systems are involved. Appropriate health care includes: self-care after diagnosis;
doctor's treatment; dilatation and curettage (D & C, See Glossary); psychotherapy or counseling, if the amenorrhea is stress-related.
SIGNS & SYMPTOMS
Absence of menstrual periods for 3 or more months in a female who has menstruated at least once.
CAUSES
Pregnancy (if your daughter has had sexual intercourse).
Breast-feeding an infant.
Discontinuing use of birth-control pills.
Emotional stress or psychological disorder.
Surgical removal of the ovaries or uterus.
Disorder of the endocrine system, including the pituitary, hypothalamus, thyroid, parathyroid, adrenal, and ovarian glands.
Diabetes mellitus.
Tuberculosis.
Obesity, anorexia nervosa, or bulimia.
Strenuous program of physical exercise, such as long-distance running.
RISK FACTORS
Stress; poor nutrition; use of certain drugs, such as narcotics, phenothiazines, reserpine, or hormones.
PREVENTING COMPLICATIONS OR RECURRENCE
If your daughter's amenorrhea is caused by an underlying disease, such as tuberculosis, diabetes, or anorexia nervosa, obtain treatment for the primary disorder.
If the cause of your daughter's amenorrhea is unknown, there are no specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as a pregnancy test, blood studies of hormone levels, and Pap smear (See Glossary).
Surgical diagnostic procedures, such as laparoscopy or hysteroscopy (See Glossary for both).
Therapeutic trial of progesterone. If bleeding occurs after progesterone is withdrawn, ovulation is occurring.
POSSIBLE COMPLICATIONSNone expected if no serious underlying cause can be discovered.
PROBABLE OUTCOME
Amenorrhea is not a threat to your daughter's health. Whether it can be corrected varies with the underlying cause:
If from pregnancy or breast-feeding, menstruation will resume when these conditions cease.
If from discontinuing use of oral contraceptives, periods should begin in 2 months to 2 years.
If from endocrine disorders, hormone replacement usually causes periods to resume.
If from eating disorders, successful treatment of the disorder is necessary for menstruation to resume.
If from diabetes or tuberculosis, menstruation may never resume.
If from strenuous exercise, periods usually resume when exercise decreases.
TREATMENT
HOME CARESee Appendix 19 for suggestions to reduce your daughter's stress.
MEDICATION
Your doctor may prescribe hormone replacement therapy.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your daughter's periods have ceased for 3 or more months.
Periods don't resume in 6 months, despite treatment.
New, unexplained symptoms develop. Hormones used in treatment may produce side effects.
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