Amenorrhea

Did you know that menstrual abnormalities affect up to 75% of adolescent females and account for a large portion of visits to the doctor as well as for missed school? Dr. Nirupma Sharma, a pediatric hospitalist with prior training in obstetrics and gynecology, joins medical students Mary Beth Mahaffey and Lauren Brewer to discuss evaluation of a common menstrual abnormality, amenorrhea, in a female adolescent patient. Specifically, they will:

• Define amenorrhea and distinguish between primary and secondary causes.
• Discuss important aspects of the history and physical exam, as well as interpretation of relevant labs.
• Review the presentation and initial diagnostic workup of the female athlete triad, also known as functional hypothalamic amenorrhea.
• Overall, provide guidance for pediatricians in recognizing disorders related to amenorrhea to allow for early detection and promotion of proper treatment and referral when necessary.
• Special thanks to Dr. Erin Latif and Dr. Rebecca Yang for peer reviewing this episode.

FREE CME Credit (requires free sign-up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11408

References: 

• https://www.aafp.org/afp/2013/0601/p781.html
• https://www.ncbi.nlm.nih.gov/books/NBK279144/
• https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign
• https://pedclerk.uchicago.edu/sites/pedclerk.uchicago.edu/files/uploads/035070025.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435916/
• https://www.ncbi.nlm.nih.gov/books/NBK279144/
• https://pubmed.ncbi.nlm.nih.gov/6379175/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188290/
• https://www.aafp.org/afp/2000/0601/p3357.html
• https://pediatrics.aappublications.org/content/138/2/e20160922
• https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods
• https://pubmed.ncbi.nlm.nih.gov/27423183/
• https://pubmed.ncbi.nlm.nih.gov/19609045/
• https://www.ncbi.nlm.nih.gov/books/NBK554469/
• https://pubmed.ncbi.nlm.nih.gov/32119508/
• https://www.ccjm.org/content/85/4/313.long
• https://www.ncbi.nlm.nih.gov/books/NBK430787/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388220/#b6-oajsm-8-085
• https://bjsm.bmj.com/content/48/4/289.long