Académique Documents
Professionnel Documents
Culture Documents
Eugonadotropic amenorrhea:
Causes: A. Congenital abnormalities of genital tract.
• Rokitanski Kuster Hauster syndrome – Problems with muller duct. No uterus but
ovaries are normal. So steroid hormones are normal. Combined urinary system
malformations produced.
• Hymen occlusivum – No hole in the hymen. It will results in hematocolpus and
hematometria. Blood goes via fallopian tubes to the abdomen and cause acute
abdomen.
• Septa vaginae – Transverse vaginal septa, usually in upper 1/3 of the vagina
where fusion of parts of mullerign and urogenital sinus.
• Absent vagina.
B. Acquired abnormalities.
• Asherman’s syndrome – Damage of deep basal layer of the endometrium
following D and C will results in formation of adhesions in the cavity. It’ll cause
sterility too.
• The development is similar as in Asherman’s syndrome, but the damage is of
infectious origin.
• Stenosis of cervical canal.
Diagnosis:
• Pelvic examination – Presence of absence of vagina, uterus, vaginal
abnormalities.
• Hormonal evaluation.
• History of currentage, TBC.
• Clinical presentation.
• US.
• X-ray.
• Laparoscopy.
• Asherman’s syndrome can be diagnosed by administration of conjugated estrogen
2.5 mg orally for 25 days + Medraxyprogesterone acetate 10 mg orally from 16
till 25th day. Patients with Asherman’s syndrome do not bleed following this
regimen.
D. Testicular feminization:
46 XY karyotype. A testis with defective enzymes will produce mullerian
inhibiting factors but not testerone. Affected individuals have female ext. genitaliaand no
mullerian structures. Breasts are well formed. Vulva is normal. “Testes” may be localized
in abdomen or in groin with excessive development of interstitial cells. After
development of 2dry sexual characteristics, abnormal testes should be removed to prevent
malignant changes.
E. Acquired factors:
Radiation. Chemotherapy. Ovarectomy. Mumps oopheritis.
Diagnosis:
• Clinics, Family history, Pelvic examination.
• Hormonal evaluation.
• Karyotyping.
• Us, CT, X-ray, Laparoscopy.
Report prepared by
1. Dr. Sajid Mahmood, MD (EU), Accident & Emergency Department, NHS Royal infirmary Liverpool United
Kingdom.
2. Dr. Adnan Akram, MD (EU), Department of Infectious Diseases. University Hospital Riga Latvia.
3. Dr. Aftab Ahmed, MD (EU), Infection Control Department, Kaunas Medical University Clinic. Lithuania.