amenorrhea-妇产科-仁济临床医院

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1、AmenorrheaDIWENM.D.,Ph.D.,Professor&ChairmanDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedtoSJTUSchoolofMedicineAmenorrheaAmenorrheaistheabsenceofmenstruation.PrimarySecondaryAbsenceofmensesbyage16withnormalsecondarysexualcharacteristicsAbsenceofme

2、nsesbyage14withoutsecondarysexualdevelopmentAbsenceofmensesfor6monthsinapreviouslymenstruatingfemale2006-11-15七年制2AmenorrheaEventsofPubertyThelarche(breastdevelopment)RequiresestrogenPubarche/adrenarche(pubichairdevelopment)RequiresandrogensMenarcheRequires:

3、GnRHfromthehypothalamusFSHandLHfromthepituitaryEstrogenandprogesteronefromtheovariesNormaloutflowtract2006-11-15七年制3AmenorrheaP1P5P4P3P2Tanner‘s2006-11-15七年制4AmenorrheaClassificationofamenorrheahypothalamicamenorrheapituitaryamenorrheaovarianamenorrheauterin

4、eamenorrhea2006-11-15七年制5AmenorrheaEtiologyhypothalamicamenorrheaPsychologicalstress5a-ReductasedeficiencyAnorexianervosa,weightlossIncreasedexerciselevelsKallmannsyndromedrug-inducedamenorrheaSpace-occupyinglesionofCNS2006-11-15七年制6AmenorrheaEtiologypituita

5、ryamenorrheatumorEmptysellasyndromeSheehansyndrome2006-11-15七年制7AmenorrheaEtiologyovarianamenorrheaGonadaldysgenesisTurnersyndrome:lowhairline,webneck,shieldchest,andwidelyspacednipples)SwyersyndromeresistantovarysyndromePrematureovarianfailure2006-11-15七年制8

6、AmenorrheaTunnerstaging2006-11-15七年制9AmenorrheaAcanthosisnigrans2006-11-15七年制10AmenorrheaStriae2006-11-15七年制11AmenorrheaTypicalfeaturesofTurnerSyndrome2006-11-15七年制12AmenorrheaEtiologyuterineamenorrheaAbsenceofuterusAshermansyndromeanatomicabnormalitiesofthe

7、reproductivetractImperforateHymen2006-11-15七年制13AmenorrheaImperforateHymen2006-11-15七年制14AmenorrheaMayer-Rokitansky-Kuster-HauserSyndrome(utero-vaginalagenesis)15%ofprimaryamenorrheaNormalsecondarydevelopment&externalfemalegenitaliaNormalfemalerangetestoster

8、onelevelAbsentuterusanduppervagina&normalovariesKaryotype46-XX15-30%renal,skeletalandmiddleearanomalies2006-11-15七年制15AmenorrheaAndrogenInsensitivityNormalbreastsbutnosexualhairNormallookingfema