Absence of menstruation has always been a common problem in obstetrics and gynecology. Patients who come to see a doctor range from 13 to 50 years old. But there are hundreds of different diagnostic scenarios to think about. Today, please imagine a scenario: a female college student in her twenties walked into the clinic with a sad face, "What should the doctor do... I used to have normal menstruation... ...But it's been three months since I came, is there something wrong with my body?" Hey, this sentence hides two clues: Past periods are normal. Of course, we must ask carefully about the cycle, duration, menstrual flow, etc., but if it is really normal, we can be very happy to know that her hypothalamus, pituitary gland and ovarian function were normal in the past, then the probability of recovery after finding out the problem higher. Three months without menstruation, chronic menstruation without menstruation for three months has reached the medical standard of amenorrhea.
In obstetrics and gynecology, the first step we have to exclude is of course pregnancy. Nowadays, the concept of contraception has become much number list more prevalent than in the past, but it is still not uncommon to have occasional contraceptive failures, especially those who use contraceptive methods such as rhythm or external ejaculation. Lots of friends. rs=w_1280 Photo Credit: Elephant Doctor I think everyone who has seen the title will know that this time I am going to talk about the relationship between being underweight, stressed or obese and amenorrhea. But I want to talk to you first, normal menstruation generally needs those perfect cooperation to complete. The hypothalamus secretes the gonadotropin-releasing hormone GnRH to the pituitary gland, ordering them to carry out the next order The anterior pituitary gland that receives the command secretes a large amount of follicle-stimulating hormone FSH and luteinizing hormone LH, and the FSH and LH that hold the command from the pituitary gland immediately go to the ovary to perform production work. In the ovary, FSH makes a group of follicles start to grow. When the follicles grow, estrogen is also produced.
The raw material of estrogen comes from cholesterol. On the one hand, this estrogen causes the endometrium to thicken; When the concentration reaches another peak, let LH rise and stimulate the broken eggs. After the follicle ruptures, the egg is released in the fallopian tube and waits for fertilization, and the remaining part forms the corpus luteum with abundant blood flow, which can secrete progesterone to maintain the thickness of the endometrial lining. Create a breeding ground for the fertilized egg to implant. If there is no fertilization, the lining of the uterus collapses, forming a blood clot, which is what we call menstruation. It will be over in about five to seven days. Doctor Elephant, why is it so complicated? Why don't you introduce today's amenorrhea? Don't panic, I have a reason for doing this, because it is very complicated to directly memorize and recite the reasons for not having menstruation. As long as the previous process is clear, you will know that any problems in the previous steps will lead to no menstruation. Finally, we are about to enter today's main axis, the so-called Functional Hypothalamic Amenorrhea. Let us explain the words.