How to distinguish between physiological and pathological amenorrhea?
summary
Amenorrhea is a common symptom in gynecological diseases. It can be said that every woman will experience it. As a woman, you know the symptoms of amenorrhea, clinical manifestations, and how to deal with them. How much do you know about them? So let me introduce you some knowledge about amenorrhea.
How to distinguish between physiological and pathological amenorrhea?
Pathological amenorrhea clinical manifestations, clinical symptoms gradually appear, initially can feel periodic abdominal distension, pain, progressive aggravation, hematoma compression urethra and rectum, can cause urination and defecation difficulties, suprapubic spasmodic pain, anal distension, frequent urination, urgency, pain, and even drip urination. When there is a large amount of blood in the uterine cavity, it can lead to ureteral displacement, distortion, hydronephrosis, and even hydronephrosis. When the blood flows into the pelvic cavity, it can stimulate the peritoneum to produce severe abdominal pain. Abdominal examination can touch a tenderness obvious mass, deep tenderness, a few patients can have mild muscle tension, rebound pain. Gynecological examination found that thin hymen bulge, no opening, the surface was purple blue. Anal examination can touch vaginal hematoma, uterine enlargement, tenderness, double attachment for sausage like strip mass, tenderness. Patients with long course of disease may have irregular thickening and varying numbers of tender nodules. B-mode ultrasound or CT examination can detect vaginal barreled cystic and solid masses, intrauterine and tubal effusion.
Amenorrhea can be divided into physiological and pathological. Pre puberty, pregnancy, lactation, postmenopausal menstruation stop, are physiological amenorrhea. What we discuss here is only the problem of pathological amenorrhea. Menstruation is caused by the periodic regulation of hypothalamus pituitary ovary axis, resulting in the formation of endometrial cycle shedding. Therefore, any organic or functional changes in the hypothalamus, pituitary, ovary and reproductive tract, especially the uterus, may cause amenorrhea. The organic and functional abnormalities of other endocrine glands may also affect menstruation and lead to amenorrhea.
Vaginal atresia: clinical manifestations of primary amenorrhea, periodic abdominal pain, etc. Gynecological examination showed vulva dysplasia, hymen without hole, but the surface color was normal, no outward bulge sign. During anal examination, it could be found that there was a vaginal cystic mass protruding to the rectum about 3cm above the vulva, and the tension of the mass was high in abdominal pain. Under the guidance of B-ultrasound, a cystic barreled mass can be detected 3-4cm above the anus. Old dark red blood or chocolate like paste can be extracted from the mass through vulva puncture. The clinical manifestations of type II were primary amenorrhea, periodic lower abdominal pain and so on. In gynecological examination, there is a mass with a diameter of 4-8cm on one side or higher in the pelvic cavity, which is a malformed uterine or adnexal mass.
matters needing attention
The determination of pituitary hormone is especially important for the diagnosis of amenorrhea. The serum levels of FSH, LH and prolactin (PRL) should be further measured in patients with amenorrhea and low estrogen. If FSH and LH are increased, it is suggested that ovarian amenorrhea. If FSH and LH are decreased, the cause may be pituitary or hypothalamus; FSH and LH are equivalent to the level of normal follicular phase. Amenorrhea is caused by hypothalamic secretion dysfunction; If LH is increased but FSH is relatively insufficient, the diagnosis of PCOS should be considered; If PRL is abnormally elevated, amenorrhea is caused by hyperprolactinemia, the cause of hyperprolactinemia should be further examined, especially the possibility of pituitary tumor.
