amenorrhea-妇产科-仁济临床医院-精选文档.ppt

Amenorrhea DI WEN M.D., Ph.D., Professor Chairman Department Of Obstetrics Gynecology Renji Hospital Affiliated to SJTU School of Medicine Amenorrhea Amenorrhea is the absence of menstruation. Absence of menses by age 16 with Primary Secondary 2006-11-15 七年制 normal secondary sexual characteristics Absence of menses by age 14 without secondary sexual development Absence of menses for 6 months in a previously menstruating female Amenorrhea 2 Events of Puberty ? Thelarche (breast development) Requires estrogen ? Pubarche/adrenarche (pubic hair development) Requires androgens ? Menarche Requires: GnRH from the hypothalamus FSH and LH from the pituitary Estrogen and progesterone from the ovaries Normal outflow tract 2006-11-15 七年制 Amenorrhea 3 P1 P2 P3 P4 P5 Tanner‘s 4 2006-11-15 七年制 Amenorrhea Classification of amenorrhea ? hypothalamic amenorrhea ? pituitary amenorrhea ? ovarian amenorrhea ? uterine amenorrhea 2006-11-15 七年制 Amenorrhea 5 Etiology ? hypothalamic amenorrhea Psychological stress 5a-Reductase deficiency Anorexia nervosa, weight loss Increased exercise levels Kallmann syndrome drug-induced amenorrhea Space-occupying lesion of CNS Amenorrhea 2006-11-15 七年制 6 Etiology ? pituitary amenorrhea tumor Empty sella syndrome Sheehan syndrome 2006-11-15 七年制 Amenorrhea 7 Etiology ? ovarian amenorrhea Gonadal dysgenesis Turner syndrome: low hair line, web neck, shield chest, and widely spaced nipples) Swyer syndrome resistant ovary syndrome Premature ovarian failure 2006-11-15 七年制 Amenorrhea 8 Tunner staging 2006-11-15 七年制 Amenorrhea 9 Acanthosis nigrans 2006-11-15 七年制 Amenorrhea 10 Striae 2006-11-15 七年制 Amenorrhea 11 Typical features of Turner Syndro