AMENORRHEA闭经0911课件

*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,A,MENORRHEA 闭经,董卫红,M.D., Ph. D,Department of OB&GY,Union Hospital of HUST,Definition,:,Amenorrhea means complete absence of menstruation in patients during the reproductive years.,It is not a disease, but a symptom.,Before puberty:,The stage of adolescence in which an individual becomes physiologically capable of sexual reproduction.,Pregnancy:,Postpartum:,Of or occurring in the period shortly after childbirth,Postmenopausal:,Of or occurring in the time following menopause.,Physiological amenorrhea,Pathological amenorrhea :,Primary amenorrhea,: absence of menses,at age,14years,when there is,no,visible,secondary,sexual characteristic development,at age,16years,in the presence of normal secondary sexual characteristics,Secondary amenorrhea,A woman who has previously menstruated absence of menstruation for three normal menstrual cycles or 6 months,Amenorrhea Mechanism,any of the,components,: nonfunctional,hypothalamus, pituitary, ovary, outflow tract, feedback mechanism,bleeding cannot occur. (Amenorrhea),Normal menstrual cycle,Events of Puberty,Menarche,Requires:,GnRH from the hypothalamus,FSH and LH from the pituitary gland,Estrogen and progesterone from the ovaries,Endometrium,Normal outflow tract,Hypothalamic amenorrhea,Psychological stress,Anorexia nervosa, weight loss,Increased exercise levels,Kallmann syndrome,：,嗅觉缺失综合症,drug-induced amenorrhea,Space-occupying lesion of CNS,Pituitary amenorrhea,Tumor,泌乳素肿瘤,Empty sella syndrome,蝶鞍隔破坏,Sheehan syndrome,腺垂体缺血坏死,Ovarian amenorrhea,Gonadal dysgenesis,性腺先天发育不全,Turner syndrome: 45,XO low hair line, web neck, shield chest, and widely spaced nipples,Swyer syndrome 46,XY,resistant ovary syndrome,继发性病变,Premature ovarian failure,功能衰竭,Uterine amenorrhea,Absence of uterus,Asherman syndrom,abnormalities of the reproductive tract,Imperforate Hymen,Imperforate Hymen,Diagnosis,Primary amenorrhea,Anatomy,Genesis,Second amenorrhea,Uterus,Ovary,Pituitary,hypothalamus,Work up of secondary amenorrhea,Second amenorrhea,Uterus:,TSH ,Prl, FSH normal, no withdrawal bleeding,Ovary:,FSH,30IU/L,LH/FSH,2,Pituitary:,FSH,5IU/L,LH,5IU/L,Hypothalamus:,FSH,5IU/L,LH,5IU/L,Thank you,