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Abstract

Primary amenorrhea

Primary amenorrhea, the absence of menarche until the age of 16, can be caused by several factors. A careful anamnesis and a clinical examination with a focused sampling of laboratory parameters can usually help to identify the cause. Useful indicators can be derived from the physical development of the patient, especially development of the breasts. When there is no menarche despite a normal puberty development, this is likely due to anomalies of the outflow tract. When there is no puberty development, the level of FSH is important: lack of gonadal function is marked by high FSH levels. In these cases, further examination should always include a chromosomal analysis, because there is the small risk of a malignant gonad development. Low FSH levels make a hypophysian or hypothalamic dysfunction or a constitutional developmental retardation likely. Hirsutism or acne are an indication of high androgen levels and possibly a PCOS. Other causes, for example AGS, are however also possible.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2017; 13(1): 4–20

Keywords
Primary amenorrhea, Muellerian agenesis, gonadal dysgenesis, pituitary disorders, hypothalamic disorders

Bernd Hinney
Grotefendstraße, Göttingen
Reviewer: Julia Bartley, Berlin,
und Bele Jakisch, Hamburg

Hinney B. Primäre ... Gynakol Geburtsmed Gynakol Endokrinol 2017; 13(1): 4–20 publiziert 31.03.2017 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2017 ISSN 1614-8533