Amenorrhea in Adolescent Girls - Essay Example

Amenorrhea in Adolescent Girls The absence of spontaneous menses in a female at adolescent age is known as amenorrhea. There could be several causes to the condition of amenorrhea. The paper attempts to explore the possible causes of amenorrhea in adolescents. Currently, 98% of girls reach menarche by the age 15. It is appropriate to look at its causes when a female has failed to menstruating by that time. Time gap between thelarche to menarche is 2.5 years for white girls and little higher for black girls.

That means if 3 years have gone after thelarche, it is necessary to evaluate the reasons. It has been gathered that 75% girls begin breast development by age 11.5 years. By age 12 more than 95% girls begin breast development. So it is perfectly fine to evaluate no menstruation state after age of 13 years. Eating disorders is considered one of the causes of primary amenorrhea. Appropriate evaluation and referral becomes necessary in such cases. Around 0.3% to 0.5% of young women are found to have the condition of Anorexia Nervosa and majority of the cases are in age group of 15 to 19 years.

While diagnosing anorexia nervosa, amenorrhea is found as one of necessary features. Other contributing factors are excessive exercise, low body weight, and stress -induced activation of the hypothalamic function. Low body weight and amenorrhea has some kind of relationship; however, it is not always the case. It has been found that around 20% of the women with anorexia nervosa have been found to develop amenorrhea before they lose significant body weight. It is important to notice that young women with bulimia nervosa are of normal weight even then they are found to suffer from irregular menses, perhaps due to dietary restriction.

At times, many women do have some kind of eating disorders that cannot be classified as anorexia nervosa or bulimia nervosa adolescents but they are part of an eating disorder not otherwise specified (EDNOS) and some of them are also found to have amenorrhea. Usually, weight restoration and nutritional food resumes menses. Amenorrhea may also occur due to prolong use of antipsychotic medication. Antipsychotic drugs have been found to block dopamine D2 receptors increasing prolactin secretion by 5-10 times from the pituitary gland.

Antidepressants too have been found to increase prolactin levels. Contraceptives in injectable form also cause amenorrhea. The use of medroxyprogesterone acetate (DMPA) causes amenorrhea in 50% of cases and that number increases to 75%, if its use continues for two years. Stress, physical or psychosocial, disrupts homeostasis. Owing to this, body energy gets diverted to the essential systems such as cardiovascular and central nervous system from nonessential ones such as reproductive system. Chronic illness too can cause delay in menses.

Chronic illnesses lead to nutritional deficiencies, metabolic and hormonal disruptions and that in turn, may lead to amenorrhea. Similarly, hypothyroidism and hyperthyroidism both may lead to amenorrhea. Certain conditions such as Cushing syndrome may cause amenorrhea. The patient must be asked for the past history followed by physical examination to ascertain whether amenorrhea is primary or secondary. Height and weight measurements should be done accurately to calculate body mass index of the adolescent.

Patients age at thelarche and her mothers age at menarche needs to be found out. If she is doing any exercise then its details must be taken from the patient. If she is taking any medication then that must be known to ascertain the correct reason for amenorrhea. ReferencesGolden, N. H. & Carlson, J. L. (2008). The Pathophysiology of Amenorrhea in the Adolescent. New York Academy of Sciences. Retrieved May 3, 2014 from http://peds.stanford.edu/Rotations/adolescent_medicine/documents/menstrual-disorders/AdolescentAmenorrhea.

pdfMaster-Hunter, T. and Heiman D. L. (2006). Amenorrhea: Evaluation and Treatment. American Family Issue. Retrieved May 3, 2014 from http://www.aafp.org/afp/2006/0415/p1374.html