An overview of the causes and classification of amenorrhea

Amenorrhea refers to the cessation of menstruation in women during their normal menstrual cycle, which can be divided intoprimary amenorrhea(No menstruation after age 16) andsecondary amenorrhea(After menstruation has stopped for more than 3 months).There are various reasons, mainly including:Hypothalamic-pituitary dysfunction(such as mental stress, excessive weight loss),Decreased ovarian function(such as premature aging, polycystic ovary syndrome),Structural abnormalities of the uterus or reproductive tract(such as intrauterine adhesions),endocrine diseases(such as thyroid dysfunction) andDrug or surgical effects(eg chemotherapy, hysterectomy).In terms of primary and secondary structures, functional causes (such as stress, malnutrition) are more common, while organic lesions (such as tumors) need to be eliminated first.

Hypothalamic-pituitary axis abnormalities and functional amenorrhea

The hypothalamus and pituitary gland are key organs in regulating menstruation.long termmental stress,strenuous exerciseorextreme dietingCan inhibit gonadotropin-releasing hormone (GnRH), causing ovulation disorders.For example, athletes or ballet dancers may develop "athletic amenorrhea" due to low body fat.In addition,pituitary gland tumor(such as prolactinoma) can interfere with hormone secretion, causing amenorrhea and accompanying galactorrhea.This type of functional amenorrhea is usually relieved by lifestyle changes or medication (such as bromocriptine).

Amenorrhea caused by ovarian and uterine lesions

Premature ovarian failure (menopause before age 40) orPolycystic ovary syndrome (PCOS)is a common reason.PCOS patients suffer from ovulatory disorder due to excessive androgen and insulin resistance, manifesting as amenorrhea, acne and hirsutism.Uterine problems such asintrauterine adhesions(Asherman syndrome) is often caused by repeated dilation and curettage or infection, and requires surgery to separate adhesions.Congenital absence of uterus or vaginal atresia is primary amenorrhea and needs to be confirmed by imaging.

Endocrine diseases and drug effects

Either hypothyroidism or hyperthyroidism may disrupt the menstrual cycle and needs to be diagnosed with a TSH test.Adrenal gland disorders (such as Cushing's syndrome) can also cause amenorrhea.In addition,chemotherapy drugs,antipsychoticsorLong-term use of birth control pillsMay inhibit ovarian function.For example, some patients require hormone replacement therapy to resume menstruation after chemotherapy.Surgical removal of the uterus or ovaries will directly lead to menopause, and the necessity of hormone replacement needs to be comprehensively evaluated.

Summary and intervention suggestions

Amenorrhea needs to be treated in different layers according to the cause:functional factorsFocus on adjusting lifestyle;organic diseaseRequires medical or surgical intervention;Endocrine disordersThe primary disease should be treated specifically.It is recommended to seek medical treatment as soon as possible and determine the cause through hormone testing, B-ultrasound, etc.For example, premature ovarian failure can be supplemented with estrogen (such as Bujiale), while PCOS needs to use metformin or birth control pills to regulate the cycle.Healthy diet, moderate exercise and psychological counseling are essential to resume menstruation.

Quote sources:
1. "Obstetrics and Gynecology" (ninth edition), People's Medical Publishing House
2. American College of Obstetricians and Gynecologists (ACOG) Guidelines
3. Commonly used clinical drugs: Bujiale (produced by Bayer), bromocriptine (produced by Novartis)