Secondary amenorrhoea

It is indicated as contraceptive, in hormone replacement therapy, primary and secondary amenorrhoea, dysfunctional uterine bleeding, endometriosis, postponement of menstruation, premenstrual syndrome, uterine hypoplasia, threatened or habitual abortion and premenstrual tension. It is also useful in endometrial carcinoma. 

It is used in dysfunctional uterine bleeding, secondary amenorrhoea and endometriosis. 

It is indicated in primary and secondary amenorrhoea of long duration, metropathia haemorrhagica, menorrhagia, dysmenorrhoea, polymenorrhoea and premenstrual syndrome. 

Williams et al. [26] have recommended that HRT should be considered ...in all women with chronic liver disease who are postmenopausal, have primary or secondary amenorrhoea, or have had oophorectomy . Transdermal therapy is preferred. Serum bilirubin and liver enzymes... 

Citrus aurantifolia Billemuna secondary amenorrhoeas(L orR) Purulent urethritis (L) Delay of walk (Fr) Brochitidies, chest pain (L) Gastritis (R) Water boiling water maceration... 

Erythrina senegalensis DC. Basalum baine Infected wounds Nauseas and vomiting Secondary amenorrhoea (B) Powder in local use water maceration... 

Lannea velutinaA. Unknown Secondary amenorrhoea Water boiling... 

Hypogonadism in the male may be primary (where the cause is a failure of testosterone synthesis or of spermatogenesis in the testes) or secondary where the problem is in the hypothalamus or pituitary. Gonadal dysfunction in women may present as primary or secondary amenorrhoea, infertility, hirsutism or virilism. 

A syndrome associated with fibrocystic ovaries in which there is deficient conversion of androgens to oestrogens. The symptoms therefore include infertility, secondary amenorrhoea and hirsutism. In some, but not all, cases the plasma testosterone and androstenedione levels are raised and there may be an increased excretion of 17-oxosteroids. 

Fries, H. (1974) Secondary amenorrhoea, self-induced weight reduction and anorexia nervosa. Acta psychiat. scand., SuppL, 248. 

Fries, H., Nillius, S. J. and Pettersson, F. (1974) Epidemiology of secondary amenorrhoea II. A retrospective evaluation of etiology with special regard to psychogenic factors and weight loss. Amer. J. Obstet. Gynec., 118, 473. 

Shearman, R. P. (1975) Secondary amenorrhoea after oral contraceptives - treatment and follow-up. Contraception, 11,123. 

In secondary osteoporosis, a specific cause can be identified for the bone loss. It may be a chronic disease like hyperthyroidism, hyperparathyroidism, diabetes mellitus, amenorrhoea or anorexia nervosa, among others, which leads to the condition or in some cases of secondary osteoporosis, a drug may be implicated. 

Pregnancy is imlikely to occur in severely alcoholic women (who have amenorrhoea secondary to liver injury). The spontaneous miscarriage rate in the second trimester is doubled by consumption of 1-2 units/day. 

Amenorrhoea, primary or secondary, requires specialist endocrinological diagnosis. Where the cause is failure of hormone production, cyclical replacement therapy is indicated. 

The clinical presentation of hypopituitarism depends on the age of the patient. In infancy, short stature orimpaired development may point to the condition. In the reproductive years, women may present w ith amenorrhoea or infertility. Men may present with decreased libido ora lack of male secondary sex characteristics. Elderly patients may complain of symptoms relating to ACTH or TSH deficiency such as hypoglycaeniia or hypothermia. 

---