Amenorrhea (absence of
menstruation) is by far the most common symptom in patients in whom an
altercation is responsible for ovulatory infertility. Amenorrhoea is
sub-classified into:
Primary Amenorrhea:
14 years of age with absence of menstruation and
secondary sexual characteristics
16 years of age with absence of menstruation, regardless
of stage of development
Secondary amenorrhea:
1 year without menses after
menstruation is established
Primary amenorrhea is most often due to
hormonal deficiency, while secondary amenorrhea may be hormonal or may
be due to other factors, such as polycystic ovary syndrome (see below)
or a very low body weight (eg, emerging in response to anorexia nerve)
(see table). Amenorrhoea usually responds well to hormone treatment,
although the weight should be increased if the low weight is a
contributory factor.
