Adolescent amenorrhea

Amenorrhea in the adolescent population is of great importance because this is the time in the female life cycle when peak bone mass is achieved. The cause of amenorrhea and appropriate treatment must be identified promptly in this population because hypoestrogenism contributes negatively to bone development. Estrogen replacement, typically via an OC, is important. In addition, ensuring that the patient is receiving adequate amounts of calcium and vitamin D is imperative. 

Efficacy Normal breast development (especially primary amenorrhea in adolescents) preservation/improvement of BMD return of menses. 

Gordon CM, Nelson LM. Amenorrhea and bone health in adolescents and young women. Curr Opin Obstet Gynecol 2003 15 377-384. 

In a normal ovulatory menstrual cycle, menstruation occurs every 28 days on average. Normal women display considerable variation in cycle length that varies from 25 to 30 days." Amenorrhea, the absence of menstrual bleeding, is traditionally categorized as either primary (women who have never menstruated) or secondary (women in whom menstruation is present for a variable time and then ceases). Amenorrhea is a relatively common disorder, with an estimated prevalence of 5% in the general population and as high as 8.5% in an unselected adolescent postpubescent population. ... 

Adolescents and women with primary or secondary amenorrhea, due to diet, excessive exercise, or hypothalamus-pituitary-ovarian axis disorders, have lower BMD than other age-equivalent individuals. 

Csermely T, Halvax L, Schmidt E, etal. Occurrence of osteopenia among adolescent girls with oligo/amenorrhea. Gynecol Endocrinol 2002 16 99-105. 

Failure of normal development of the mullerian ducts causes uterine agenesis or hypoplasia. Patients present with primary amenorrhea in adolescence. Agenesis or hypoplasia of any part of the genital tract (vagina, cervix, uterus, tubes) may occur either in isolation or, more, commonly, in combination. This relatively uncommon class of anomalies accounts for approximately 5% of mullerian duct anomalies. Vaginal agenesis is the most common subtype, and is often accompanied by uterine agenesis. 

Pediatric radiologists will commonly come across mUllerian duct anomalies at two different stages of a girl s life. In neonates diagnostic requests encompass evaluation of a palpable abdominal mass and delineation of associated genital malformation in urogenital sinus anomalies. In adolescent girls delay in puberty or primary amenorrhea as well as pelvic... 

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