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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]
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.
Hyperandrogenism is a medical condition characterized by high levels of androgens.It is more common in women than men. [4] Symptoms of hyperandrogenism may include acne, seborrhea, hair loss on the scalp, increased body or facial hair, and infrequent or absent menstruation.
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]
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 ...
[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.
If enough weight is gained due to increased body fat deposits, one may become overweight or obese, generally defined as having more body fat (adipose tissue) than is considered good for health. [1] The Body Mass Index (BMI) measures body weight in proportion to height and defines optimal, insufficient, and excessive weight based on the ratio. [2]