Abstract
Approximately 40% of adolescents present menstrual disorders during the first 2 gynecological years. The absence of menses is defined as amenorrhea and is classified as primary or secondary.
The classification of primary amenorrhea, in relation to the etiology of the disease, includes the uterovaginal aplasia or congenital uterovaginal anomalies with obstruction, endocrine disorders, chromosomal anomalies, as well as stress and psychological problems.
Patients’ evaluation includes information taken by the clinical history, gynecological and physical examination, X-rays, utlrasonography, hormonal tests, and rarely hysteroscopy or/and laparoscopy.
Each patient should be individually treated, avoiding unnecessary tests and overtreatment. In cases presented with obstruction of the genital route immediate surgery is advised. If hormonal treatment is scheduled, the low-dose, new-generation 17β-estradiol combined oral contraceptives are recommended. Explanation, reassurance, and emotional support are necessary tools for the management of the disease, as in many cases treatment is advisable for a long period of time.
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Creatsas, G.K., Creatsas, M. (2014). Pathophysiology and Clinical Assessment of Primary Amenorrhea. In: Genazzani, A.R., Brincat, M. (eds) Frontiers in Gynecological Endocrinology. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-319-03494-2_1
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DOI: https://doi.org/10.1007/978-3-319-03494-2_1
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