Etiological factors of primary amenorrhoea: A prospective study
Author(s): Dr. Susheela BR
Abstract: Amenorrhoea is absence of menses in women of reproductive age. Primary amenorrhea is defined either as absence of menarche by 14 years of age in the absence of secondary sexual characteristics or absence of menses by 16 years in the presence of normal growth and secondary sexual characteristics. Secondary amenorrhea is characterized as the cessation of previously regular menses for three months or previously irregular menses for six months. According to World Health Organization estimates, amenorrhea stands as sixth largest major cause of female infertility and affects 2–5% of all women in the child bearing age.1,2 In the present study, 3 patients presented before 15yrs of age, 12 patients presented in the age group of 16 -20 years, 5 patients of 21-25yrs age group, 1 patients of 26-30 years age group, 1 patients of 30-40 years age group and past 40yrs was seen in 2 patients. The complaint of not having attained menarche is seen in only 11 cases, dyspareunia in 4 cases, cyclical pain abdomen in 3 cases, dysuria were seen in 2 cases, infertility and short stature was seen in 2 cases each and malnutrition was in one case. Our study found MRKH syndrome in 10 cases and HGH in 8 cases. Next most important cause is cryptomenorrhoea in 3 cases. AIS was seen in 2 cases followed by PCOS and imperforate hymen each in one case. Treatment for primary amenorrhea may start with watchful waiting, depending on the person's age and the result of the ovary function test. If there is a family history of late menstruation, periods may start in time. If there are genetic or physical problems that involve the reproductive organs, surgery may be necessary. This will not guarantee, however, that normal menstrual cycles will occur.
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