A Clinical Study of Primary Amenorrhea

Abstract

Introduction Menstruation is the physical herald to physiologic capacity of conception. Attainment of menarche in a girl brings in a lot of confidence and feminism in a girl. Though the incidence of primary amenorrhea is less than 1%, it accounts for significant amount of psychological trauma. In the present day scenario, there are a lot of investigative and treatment modalities which can at least restore her menstrual functions, if not reproductive, and prevent complications. Aims The objective of this study is to note the various causes of primary amenorrhea and the complete clinical picture and the management done in a tertiary care center like Vanivilas Hospital and Bowring Hospital, Bengaluru. Materials and methods This is a prospective study done in 40 patients of primary amenorrhea presenting to Vanivilas Hospital and Bowring and Lady Curzon Hospital, Bengaluru during a 2 years period. They were investigated and managed. The patients were followed up for their response to treatment. Results Out of the 40 patients studied, Mayer-Rokitansky- Küster-Hauser (MRKH) syndrome (32.5%) and hypergonadotropic hypogonadism (32.5%) were most common. Cryptomenorrhea (17.5%), automatic identification system (AIS) (7.5%) and miscellaneous (4%) were found. Conclusion Evidence of primary amenorrhea is less than 1%. A detailed investigation may lead to treatment in many cases. How to cite this article Anitha GS, Tejeswini KK, Shivamurthy G. A Clinical Study of Primary Amenorrhea. J South Asian Feder Obst Gynae 2015;7(3):158-166.

Prospective study of primary amenorrhoea and its management in a rural tertiary centre

“…Presenting complaint was amenorrhoea in 76% (n=19) of patients in our study, similar results were noted in studies done by Kriplani A et al, All India Medical Sciences New Delhi, Anitha et al Vani Vilas Government hospital at Karnataka and Civil hospital Ahmedabad were similar. 5,6 Cyclical abdominal pain was noted in 16% of cases in our study, similar results was noted in study done by Anitha et al, at Vani Vilas Government hospital at Karnataka.…”

“…In this study most patients presented at the age group of 16-20 years (88%), similar results were obtained in two studies conducted by Anita et al, at Vani Vilas Government hospital at Karnataka and Civil hospital Ahmedabad. 5,6 Nineteen patients belonged to low socioeco-nomic status, four were from lower middle class and two belonged to upper middle class.…”

“…Mullerian anomaly was the commonest cause of amenorrhoea in studies done by Kriplani A et al (47%), Tanmahasamut P et al 1 (39.7%), Anita et al, Vani Vilas Government hospital at Karnataka (32%) and Tushar et al, Civil hospital Ahmedabad (44%). [5][6][7][8][9] Studies done in India and other Asian countries have reported higher incidence of Mullerian anomalies as the cause for primary amenorrhoea in contrast to western studies where gonadal dysgenesis is the commonest cause.…”

“…Attainment of menarche is celebrated with grandeur in few communities. 5 Menarche marks the end of a series of events which begin in cerebral cortex and hypothalamus and terminates in uterine and ovarian tissues. It includes events such as thelarche, pubarche, growth spurt and ultimately culminating in menarche.…”

A study on chromosomal analysis of patients with primary amenorrhea

“…[2728] Primary amenorrhea may lead to anxiety, depression, and suicidal tendencies in affected individuals. [29] Providing psychological support during counseling is also very important in patients with Turner's syndrome with primary amenorrhea and sterility problem. [30] Because of high psychological and social impact, patients seeking genetic evaluation are a small fraction of affected women, and hence, the exact incidence or prevalence of amenorrhea is not known.…”