The absence of menstruation for more than six months, or their original lack of girls after 16 years - this is amenorrhea. The symptoms of amenorrhea - absence of menstrual periods and infertility are common to all types of the condition. Depending on the causes of amenorrhea Causes of amenorrhea - different circumstances   may develop other symptoms.

The main symptoms of amenorrhea

The main symptoms of amenorrhea two - lack of menstrual bleeding for more than six months, and infertility. These two symptoms are typical for any kind of amenorrhea. From the usual delay of menstruation amenorrhea The absence of menstruation (amenorrhea) - ambiguous symptom   feature time - the length of the delay never exceeds six months.

As you know, neurohormonal system that provides support for woman's menstrual cycle, includes the cerebral cortex - the hypothalamus - pituitary - ovary. Damage to any of these levels can cause amenorrhea, which is characterized by the presence of general or basic symptoms and symptoms unique to this disease. Thus, conditionally possible to allocate the hypothalamic, pituitary and ovarian amenorrhea.

Symptoms of hypothalamic amenorrhea

Hypothalamic amenorrhea or central - is the most common amenorrhea. Symptoms depend on its origin and duration of the disease. Most often it is related functionality, such as high physical, neuropsychological load, stress, poor diet, rapid weight loss, a variety of severe common diseases and so on. Under the influence of these causes a woman missing monthly and she can not get pregnant.

Central amenorrhea functional origin is usually held after the elimination of the reasons that caused it. But if these reasons are long, the ovaries may occur irreversible changes. The cause of the hypothalamic amenorrhea may also be a tumor or a disease of the hypothalamus.

With long flowing hypothalamic amenorrhea body and face girl gradually undergoes characteristic changes: weight increases, fat is stored mainly in the abdomen, pelvis, hips and breast. The face becomes round, soft leather, with a marble shade, pubic hair and armpits rare or completely absent. External genitals are usually underdeveloped, narrow vagina, the uterus is too small.

In order to detect such amenorrhea, it is necessary to investigate the blood on hormones. The absence or lack of stimulating effect on the hypothalamic-pituitary said low levels of pituitary gonadotropins (TG) with normal levels of the pituitary hormone prolactin. Also reduced the blood levels of female sex hormones. Diseases and tumors of the hypothalamus are detected using X-ray and magnetic resonance imaging.

Symptoms of pituitary amenorrhea

In contrast to the hypothalamic pituitary amenorrhea usually has an organic origin. The most common cause of the disease is bleeding or a tumor of the pituitary gland. The disease may manifest itself in a variety of syndromes. At various diseases and tumors of the pituitary gland can increase weight, height, body proportions violated. Sometimes the girls, on the other hand, lag behind in growth and physical development. Symptoms amenorrhea combined with a variety of symptoms that depend on the location, nature and extent of pituitary lesion.

For example, a typical Cushing's syndrome, which develops when the pituitary tumor. It obesity with preferential deposition of fat in the upper body, on his stomach, face. On the skin there are numerous bluish-colored stretch marks (striae), increased body hair, osteoporosis, decrease in the volume of breasts, increased blood pressure. Most developing diabetes Diabetes - threatening and incurable disease   and amenorrhea.

With the destruction of pituitary tissue by necrosis develops giporfizarnaya cachexia syndrome or Symonds: lethargy, tiredness, lack of appetite, dramatic weight loss, reduction in the size of internal organs, amenorrhea.

Symptoms of ovarian amenorrhea

Ovarian amenorrhea is most often the result of a primary ovarian failure of genetic origin. Less changes in the ovary are acquired (after a serious illness suffered by a child). For ovarian amenorrhea is of genetic origin, such as Turner syndrome, when the primary defect in ovarian tissue develops due to genetic damage. Girls with Turner syndrome are short stature, short neck, the predominance of the lower half of the body over the top. Secondary sexual characteristics are poorly developed, osteoporosis (brittle bones associated with calcium deficiency). Sometimes these symptoms are combined with other severe anomalies.

Ovarian failure may be accompanied by symptoms of early menopause (sometimes 30 years). If the sclera-cystic ovaries develop acyclic uterine bleeding Uterine bleeding outside of menstruation - a sign of a serious breach   and obesity.

Identify the cause of amenorrhea is possible only after a thorough examination of the woman.

Galina Romanenko

Amenorrhea central genesis (origin) can manifest itself in different ways, depending on what the structure of the brain and how much amazed. This group of amenorrhoea include all its types, caused by disorders of the central nervous system.

What is amenorrhea of ​​central genesis

This kind of amenorrhea is also known as the hypothalamic-pituitary axis, that is arising in any pathology in the hypothalamus or pituitary. As we know, women neurohormonal system consists of the following mutually influence each other structures: the cerebral cortex - the hypothalamus - pituitary - ovary - uterus. Failure in any of these levels can cause amenorrhea. Failure at the cerebral cortex - the hypothalamus - pituitary causes amenorrhea of ​​central origin.

All types of amenorrhoea central origin can be divided into two large groups - functional and organic. Functional changes occur without any apparent change in the structure of the brain. But changes are taking place at the biochemical level under the influence of various factors: starvation, trauma and various diseases (acute infections, frequent exacerbations of chronic diseases), intoxications, and so on.

Organic types of amenorrhea of ​​central origin are species that cause disease and tumors in the hypothalamus and pituitary gland. In the brain tissue undergoing structural abnormalities that lead to the appearance of symptoms, including amenorrhea.

Functional amenorrhea of ​​central genesis

When stress, intoxication, starvation and any other common effects on the cerebral cortex functional changes occur in subcortical structures - the hypothalamus and pituitary. It begins with the fact that the command of the cerebral cortex increases production of endogenous opioids - substances whose main task - to smooth the unpleasant consequences on the brain.

This triggers a chain reaction of this: under the influence of opioids reduces the amount of the neurotransmitter dopamine and secretion of hormones of the hypothalamus that regulate the secretion of pituitary hormones. In particular, can reduce the production of gonadotropin-Riesling-hormone from the hypothalamus, which regulates the number and the cyclical secretion of pituitary gonadotropins - follicle-stimulating hormone (FSH - a hormone of the first half of the menstrual cycle) and luteinizing hormone (LH - the hormone of the second half of the menstrual cycle).

And since under the influence of FSH and LH occurs first oocyte maturation, then its output from the ovary (ovulation) and the secretion of female hormones that prepare the uterus for pregnancy, the menstrual cycle is disrupted news Menstrual cycle and its characteristics . The mucous membrane of the uterus is not growing, it begins to secrete and then not rejected - no menstruation.

Usually, functional amenorrhea of ​​central origin goes after the cause of the disease. But its duration in the hormonal system (usually in the ovaries) can occur irreversible changes. Therefore, any amenorrhea should be treated in time.

Organic amenorrhea of ​​central genesis

Organic amenorrhea of ​​central origin caused diseases and tumors of the hypothalamic-pituitary system. This often affects the pituitary gland. And as with your pituitary hormones regulate the function of other endocrine glands, depending on the location of the lesion and its extent may appear certain symptoms, which include as amenorrhea. The most common syndromes of Skien, Cushing and gigantism.

The syndrome Skien changes in the pituitary tissue occur against the backdrop of major bleeding during childbirth, miscarriage or induced abortion. Due to the lack of blood supply (ischemia) in pituitary tissue can occur necrosis (tissue necrosis). These same disturbances may cause a thrombus to blood vessels in the pituitary. This is what causes different symptoms, which manifest in varying degrees depending on the size and location of the pituitary. May be affected by the structure responsible for control of the sex glands, thyroid gland, adrenal glands. Therefore, amenorrhea may occur against the background of other symptoms, such as failure of the thyroid gland The thyroid gland - is responsible for your hormones   (weakness, decreased performance, low blood pressure). It may be a complete defeat of all the functions of the pituitary gland, resulting in developing resistant amenorrhea, a decrease in the volume of genitals and mammary glands, hair loss, memory impairment, weakness, lethargy, weight loss.

When some organic lesions of the hypothalamus increases the secretion of hypothalamic hormones that regulate the formation of the pituitary hormone responsible for the function of the adrenal glands. This causes the formation of excessive glucocorticoid and androgen. The result is amenorrhea, male pattern changes (including increased body hair), obesity is disproportionate with the deposition of subcutaneous fat in the face, neck and upper body.

Gigantism develops in the affected area of ​​the pituitary gland responsible for the secretion of growth hormone Growth Hormone - Medicine will grow   (growth hormone - STH). Increased production of growth hormone results in increased growth, sometimes disproportionate, which in adolescence is often associated with primary amenorrhea Primary amenorrhea - a consequence of the genetic damage   or early cessation of menstruation.

Galina Romanenko