Hypergonadotrophic amenorrhea is associated with increased secretion of pituitary gonadotropins (TG). This increased activity of the pituitary gland develops in the fall of ovarian function - insufficient secretion of estrogen and progesterone by the ovaries causes the pituitary gland again and again to stimulate their work.

What causes amenorrhea hypergonadotrophic

Hypergonadotrophic amenorrhea develops when falling of ovarian function, when produced in cells of ovarian estrogen less in the first half of the menstrual cycle and progesterone during the second half. The lack of female hormones causes a stimulation of its activity on the part of the pituitary gland - the last hard starts, a large number of secreting TG - follicle-stimulating and luteinizing hormones (FSH and LH).

But ovarian stimulation HCG to nothing lead - ovarian reserves dried up. Lack of estrogen in the first half of the menstrual cycle does not allow to grow the uterus mucosa (endometrium), and the lack of progesterone - secreting fully. As a result, the menstrual cycle is disrupted, monthly disappear (starts amenorrhea), but may appear acyclic bleeding associated with indiscriminate rejection of the endometrium areas.

Reasons for decline of ovarian function may be different. This may be gonadal dysgenesis or Turner syndrome (in this case comes primary amenorrhea), depletion of ovarian syndrome, resistant ovary syndrome and normal menopause.

Hypergonadotrophic amenorrhea during gonadal dysgenesis

Gonadal dysgenesis - a collective disease, there is a group of diseases associated with the violation of the embryonic development of the sex glands, caused by genetic factors or embryotoxic. Thus, instead of the damaged tissue of the ovary develops connective tissue. Menstruation does not occur, that is developing a primary amenorrhea.

One option gonadal dysgenesis is Turner syndrome, ovarian dysfunction when combined with the violation of the overall development of girls and short stature. These girls have low growth with a short neck, a predominance of the lower half of the body over the top. Secondary sexual characteristics are weak, due to lack of estrogen developing osteoporosis - a lack of calcium in the bones, because of which the bones become fragile, prone to fractures. Sexual desire is absent

Sometimes (not often) Against this background, developing mental retardation Mental retardation - if the mind is underdeveloped , Multiple congenital anomalies: malformation of the ear, deafness, strabismus, optic atrophy, cataracts Cataracts - how to solve the problem completely? , Congenital heart disease.

Can a woman have children? Modern medicine is able to address this question in the affirmative. Carry and give birth to a child a woman can using in vitro fertilization (IVF) using donor eggs and sperm of the husband (if, of course, it does not have the anatomical structure of the genital organs disorders that prevent pregnancy).

Hypergonadotrophic amenorrhea in the wasting syndrome of resistant ovary syndrome and ovarian

On depleted ovarian syndrome (Sia) or premature menopause say in the case when the ovaries stop functioning after steady menstrual cycle. That is, first the ovaries are functioning normally, the girl set the menstrual cycle, but after some time (at any age up to 40 years) and the end of menstruation comes amenorrhea. In the blood revealed a lack of female sex hormones and an excess of pituitary gonadotropins.

When resistant ovarian syndrome (SRYA) ovaries have normal structure, but for whatever reason, are resistant (insensitive) to the stimulating effects of pituitary gonadotropins.

Patients with Sia and SRYA distinguish right physique, lack of obesity. The beginning of the disease is considered to amenorrhea or oligomenorrhea (rare scant menses), followed by persistent amenorrhea. A short time after the beginning of the violations appear typical of menopause vegetovascular symptoms - irritability Irritability - you try to control my temper , "Hot flashes", heart attacks, heart pain Pain in the heart - always consult a doctor , Sweating, weakness, headaches in violation of disability. Against the backdrop of lack of menstruation develop progressive atrophic processes in the mammary glands and genitals.

And this SRYA and require a comprehensive survey of women and to identify the causes of the disease. For this study blood on hormones, ultrasound of the pelvic organs, thyroid, adrenal, X-ray and magnetic resonance imaging of the brain.

The treatment - hormone replacement therapy. Pregnancy is only possible with the help of IVF and donor egg.

Galina Romanenko

Secondary amenorrhea - a cessation of menses for more than six months at a steady menstrual cycle. Secondary amenorrhea may be of a physiological nature, such as during pregnancy and nursing Breastfeeding - a personal choice   breast menstruation does not happen.

Causes of secondary amenorrhea

Causes of secondary amenorrhea are very diverse. Thus, secondary amenorrhea associated with disruption of the hypothalamus (the central amenorrhea) can be caused by severe neuro-psychiatric and physical (eg, sport) loads, stress, poor diet (eg, frequent fasting, extreme diets). Sometimes, the development of amenorrhea lead long and hard for the common occurring chronic diseases (a consequence of intoxication).

Sometimes the cause of the hypothalamic-pituitary secondary amenorrhea may also be diseases, injuries and tumors of the hypothalamus and pituitary gland. For example, prolactinoma (benign tumor of the pituitary gland, secreting the hormone prolactin). Prolactin inhibits the production of pituitary follicle-stimulating hormone, follicle maturation in the ovary, prolongs the existence of the corpus luteum and release of progesterone, and therefore the onset of menstruation.

Another cause of secondary amenorrhea - disorders (including hereditary and autoimmune), and ovarian tumors. Such diseases include polycystic ovarian syndrome, ovary exhaustion syndrome (Sia), resistant ovary syndrome (SRYA), benign and malignant ovarian tumors.

The cause of secondary amenorrhea may be other endocrine glands, in the first place - the thyroid and adrenal glands. Diseases, disorders and hereditary tumors in these glands can also cause amenorrhea.

The cause of secondary false (the mother), amenorrhea may be carried over abortion, obstructed labor, inflammatory processes in the uterus. All this may lead to the formation inside the uterus or within the cervical canal adhesions and accretions of preventing leakage of menstrual blood.

Moreover, the cause of secondary amenorrhea may include: taking certain drugs (antidepressants, corticosteroids, antipsychotics, antitumor agents), radiation effects, including radiation therapy, polycystic ovarian syndrome (PCOS - wherein increased levels of male sex hormones, which leads to disruption of ovarian function), rapid significant weight loss (fat cells produce estrogen).

Symptoms

Symptoms of secondary amenorrhea depends on the cause of its development. For example, if the central Secondary amenorrhea is functional in nature, it appears only in the absence of menstruation.

If the cause of amenorrhea become a pituitary tumor, it can develop Cushing's syndrome, which is manifested obesity with predominant 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.

When wasting syndrome and resistant ovarian (Sia and SRYA), when the ovaries have a normal structure, but their function or exhausted or for some reason they are resistant (insensitive) to the stimulating effects of gonadotropin-releasing hormone of pituitary women initially have normal appearance - the disease develops Only the emergence of amenorrhea before the age of 40 years. A short time after the beginning of the disturbances due to the absence of female hormones. There are typical climax vegetovascular symptoms - irritability Irritability - you try to control my temper , "Hot flashes", heart attacks, heart pain Pain in the heart - always consult a doctor , Sweating, weakness, headaches in violation of disability. Against the backdrop of lack of menstruation develop progressive atrophic processes in the mammary glands and genitals.

When false amenorrhea caused atresia cervical canal in women appear monthly cyclic abdominal pain. If amenorrhea is caused by a false adhesions in the uterus, it manifests itself only in the absence of menstruation.

Diagnostics

Since the causes of secondary amenorrhea are numerous, a woman must undergo a comprehensive examination which includes questioning and examination of the patient, blood tests for hormones, hormonal tests, ultrasound and X-rays, if necessary - magnetic resonance imaging, diagnostic hysteroscopy and laparoscopy.

Only after a thorough examination and to establish a definitive diagnosis a woman may be given treatment.