ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 EP134 | DOI: 10.1530/endoabs.63.EP134

Primary amenorrhea: clinical, biological, etiological and therapeutic features

Wahiba Abdellaoui, Abir Tahri, Imane Assarrar, Ikram Mahroug & Hanane Latrech

Department of Endocrinology-Diabetology, Mohammed VI University Hospital, Medical School, Mohamed First University, Oujda, Morocco.

Introduction: Primary amenorrhea is an uncommon presentation in reproductive medicine requiring rigorous investigation. Primary amenorrhea is defined by the absence of menstrual cycle in girls after the age of 15 years, with or without the development of secondary sexual characteristics. The objective of the study is to determine the clinical, biological, etiological and therapeutic profile of primary amenorrhea in the Endocrinology-Diabetology department of Mohammed VI University Hospital in Oujda.

Patients and methods: A retrospective study about 9 female patients with primary amenorrhea who attended the Endocrinology-Diabetology department during a 4 years period.

Result: The mean age at the diagnosis was 19 years. Primary Amenorrhea was associated with short stature in 7 patients, clinical features of Turner’s syndrome in 2 cases, a headache in 1 case and obesity in 1 case. The causes of primary amenorrhea in our series was related to hypogonadotropic hypogonadism and hypopituitarism in the context of a combined GHD in 33.3% the cases, of which 2 cases were due to an interruption of the pituitary stalk and 1 case had a normal MRI, prolactinoma in 1 case, Prader-Willi syndrome in 1 case, 2 cases were caused by chronic diseases, while 2 cases were related to Turner’s syndrome. We noted 3 cases of spinal osteoporosis as a complication of estrogen deficiency. Therapeutic management is based on estrogen-progestogen hormone replacement therapy, osteoporosis treatment, and etiological treatment.

Conclusion: The most common causes for primary amenorrhea are related to chromosomal abnormalities followed by endocrinological causes like Hypothalamic Hypogonadism and pituitary disease. The other causes include Mullerian abnormalities, congenital adrenal hyperplasia and poly cystic ovarian syndrome (PCOS). Treatment depends on the cause with emphasis on the immediate and long-term wellbeing of the patients.

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