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Secondary amenorrhea's most common and most easily diagnosable causes are pregnancy, thyroid disease, and hyperprolactinemia. [50] A pregnancy test is a common first step for diagnosis. [50] Similar to primary amenorrhea, evaluation of secondary amenorrhea also begins with a pregnancy test, prolactin, FSH, LH, and TSH levels. [13]
In the case of RED-S, the majority of secondary amenorrhea cases are attributed to functional hypothalamic amenorrhea (FHA), an adaptive mechanism to preserve energy for survival and vital processes rather than reproduction when energy balance is low. [17] [18] Primary amenorrhea is characterized by delayed menarche (the onset of menses during ...
The secretion of GnRH normally occurs in a pulsatile fashion, every 60 to 90 minutes. This is absent in exercise amenorrhoea. The function of GnRH is to stimulate the secretion of leutinizing hormone (LH) and follicle stimulating hormone (FSH). As a result, LH and to a certain extent FSH are secreted in low quantities.
Headache, nausea, vomiting, diarrhea, and fatigue may also accompany the pain. Pain may begin gradually, with the first several years of menses, and then intensified as menstruation becomes regular. Patients who also have secondary amenorrhea report symptoms beginning after age 20 and lasting 5–7 days with progressive worsening of pain over time.
Getting checked by a medical professional for hyperandrogenism — especially if one has a family history of the condition, irregular periods, or diabetes — can be beneficial. [60] A healthy weight and diet may reduce the chances, as continued exercise and a healthy diet lead to an improved menstrual cycle, decreased insulin levels, and ...
Both significant weight loss and weight gain can cause FHA through insulin. [12] Significant weight loss, as in eating disorders and chronic malnutrition, is characterized by low insulin levels. Significant weight gain can lead to obesity and insulin resistance, which mimics low insulin levels via functional hypoinsulinaemia. [12]
[30] [31] [32] Hypoestrogenism can occur in men due to hypogonadism. [33] Very rare causes include aromatase deficiency and estrogen insensitivity syndrome. [30] [31] [32] Medications can also be a cause of hypoestrogenism in men. [34] [35] Hypoestrogenism in men can lead to osteoporosis, among other symptoms.
The side effects of cyproterone acetate (CPA), a steroidal antiandrogen and progestin, including its frequent and rare side effects, have been studied and characterized.It is generally well-tolerated and has a mild side-effect profile, regardless of dosage, when it used as a progestin or antiandrogen in combination with an estrogen such as ethinylestradiol or estradiol valerate in women.