Endocrine Abstracts

Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months (1). Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency the aim of this study to analyze the clinical, biological, etiological profile of secondary amenorrhea (2).

Patients and methods: We conducted a retrospective descriptive study of 47 patients hospitalized or followed in consultation with the endocrinology department of the Mohammed VI hospital center of Oujda for a secondary amenorrhea.

Results: The mean age is 31.5 years ±8.4 years, the history have revealed tuberculosis, postpartum haemorrhage, autoimmune diseases such as dysthyroidism, diabetes, thrombocytopenia and Crohn’s disease. clinical examination we found malnutrition in 6 patients with BMI less than 18 kg/m², moderate obesity in 5 cases, hyperandrogenism is found in 7 cases, clinical signs of dysthyroidism in 5 patients, and galactorrhea are found in the majority of patients (24 cases). Biological investigations allowed us to retain: hypogonadotropic hypogonadism in 21 patients including 5 cases of panhypopituitarism, 19 cases hyperprolactinemia, hypergonadotropic hypogonadism in 2 patients. After radiological assessment, the most common etiology was pituitary adenomas, followed by isolated hyperprolactinemia, polycystic ovary syndrome, and 1 case of sheehan syndrome, primary ovarian failure in 2 cases, 3 cases of hyperthyroidia, and the rest was secondary to unbalanced chronic diseases. Patients with primary ovarian insufficiency can maintain unpredictable ovarian function and should not be presumed infertile. Patients with hypothalamic amenorrhea should be evaluated for eating disorders and are at risk for decreased bone density. Patients with polycystic ovary syndrome are at risk for glucose intolerance, dyslipidemia, and other aspects of metabolic syndrome.

Conclusion: Thus secondary amenorrhea, which is very frequent, makes it necessary to review the major chapters of the endocrinology of reproduction. Their etiological diagnosis may seem complex because the list of their causes is long (3).

Bibliography: 1. DAVID A.and Uniformed Services University of the Health Sciences, Bethesda, Maryland: Amenorrhea: An Approach to Diagnosis and Management. Volume 87, Number 11, June 1, 2013.

2. Azziz R and et al.; Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91(11):4237–4245. 42.

3. ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41–47.