Amenorrhea Diagnosis

Diagnosis for Amenorrhea need to inquire about medical history and perform many tests. Patients with primary amenorrhea, doctor would ask about the process of growth and development, childhood has been suffering from viral infection or tuberculous peritonitis. Patients with secondary amenorrhea, doctor would ask age of menarche, duration of amenorrhea, Menstrual period before amenorrhea and whether or not the spirit; whether take contraceptives, whether had hormone therapy; whether cyclical pain in the lower abdomen. If had pregnancy, inquire about the history of abortion, curettage, postpartum hemorrhage.

Some tests use to amenorrhea diagnosis include Cervical screening, Ovarian function tests, Pituitary function tests.

1. Cervical screening:

1) Hysteroscopy: shows whether the deformity of bureaucratic depth, width, shape, with or without adhesive, check the pathological changes of endometrium.
2) laparoscopy: shows the uterus and gonadal appearance, except for congenital dysplasia, if necessary, take ovarian biopsy.
3) uterine fallopian tube axis Lipiodol angiography: Understanding cavity shape, with or without deformity, whether tubal patency, except for tuberculosis.
4) drug test: progesterone and estrogen tests, to observe whether the response of endometrium.

2. Ovarian function tests:
1) vaginal mucus crystallization inspection: understanding the level of estrogen.
2) the crystallization of cervical mucus examination: understanding the level of estrogen and whether progesterone affects.
3) Determination of basal body temperature: understanding whether ovulation and luteal function.
4) Determination of estrogen and progesterone levels: understanding ovarian function.

3. Pituitary function tests:
1) Determination of blood PSH, LH concentration: if the higher than normal that prompts ovarian dysfunction; if lower than normal that indicate pituitary function lower.
2) pituitary stimulation test: 15-30 minutes after administration in general, LH values higher than 2-4 times before use drug, that is pituitary function better, if do not increase or increased very little that may be in pituitary disease.
3) serum prolactin (PRL) determination: If PRL <50ug/ml, should be further PRL. Excitement or inhibition test to identify the increased PRL secretion and pituitary adenoma.
4) sellar x-ray film, magnetic resonance imaging examination: to except for pituitary tumor.

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