Primary amenorrhea

Abstract

Primary Amenorrhea is defined as the absence of menses at age 16 when secondary sexual characteristics are present or absence of menses at age 14 when secondary sexual characteristics re not present. The prevalence of the condition at age 14 is 0.1-2.5% and the prevalence at age 16 is 1-5%. Uterus, endometrial lining, ovaries, pituitary and hypothalamus must function properly and in a harmony for the routine menstrual cycle. Primary amenorrhea results from endocrinologic ethiologies in 40% and from developmental abnormalities in 60%. The history of the patient, hormonal parameters, diagnostic tools (such as ultrasound and magnetic resonance imaging) and laparoscopy can all be useful for the diagnosis of the condition. The answers of 3 questions are important for treatment in these patients. One of them is the menstruel flow, the other is probability of pregnancy and finally sexual intercourse. Additional anomalies must be investigated when the underlying pathology is developmental anomalies. Treatment modalities must be discussed with the patient and her family. The important point is to identify the underlying pathology and to discuss the condition in terms of treatment, sexual intercourse, concieving pregnancy and prognosis. In necessary cases the patients must be consulted with a psychiatrist.