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Page 18
Problems with Menstruation
Absence of Periods
Amenorrhea is the term used to define the absence of menstruation. There are two types of amenorrhea: That which occurs when a young woman fails to start menstruating by the time she is in her midteens, and the cessation of periods once menarche has occurred for some reason other than menopause or pregnancy.
It is fairly uncommon for the first type of amenorrhea to occur. In order for a diagnosis of the cause of such a problem, the physician or other healthcare practitioner would need to have a thorough history from the patient including a family history. The physical examination is also an important tool in assessing the reasons for failure to menstruate. If periods have failed to come on by the age of 18, this type of evaluation should be undertaken. If the patient has not developed secondary female characteristics (growth of breasts, enlarged hips, public hair, etc.) by the age of 16, evaluation should occur at that time rather than waiting to age 18. Of course, anytime a problem is suspected, an evaluation including a history, physical examination and any laboratory tests which may be appropriate should be begun. The evaluation may include various tests including laboratory studies to indicate the levels of hormones present.

 
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