Amenorrhoea

Amenorrhoea : absence of menstruatino two types Primary secondary
primary amenorrhoea :failure of onset of menstruatino beyond age of 16 years regardless of development of secondary sexual character .
Classification it is made on basis of serum FSHlevel
! Hyper gonadotropic 2 eu gonadotropic 3 hypo gonadotropic
etiology: 1delayed puberty 2 cerebral stress emotional disturbane infection trauma tumor 3 hypothalamus kallmans syndrome vigorous exercise weight loss 4 pituitary gland  empty sella turcica cushings syndrome frohlich syndrome 5 ovary turner syndrome savage syndrome PCOD genital tract absent uterus refractory endometrium obstruction in lower genital tract 7 chromosomal 8 drugs anti hyper tensive 9 nutrition
MANAGEMEnt A hyper gonadotropic : there is gonadal failure or dys genesis  FSH > 4o miu/ml  chromosomal 45 xo 1 GONADECTOMY in pt of testicular feminizing syndrome 2 OOCYTE  donation 3 cyclic oestrogen and progesterone
EU gonado tropic : FSH normal  testicular feminizing syndrome with 46 xy 1 prophylactic GONADECtomy 2 oestrogen therapy 3 vagino plasty 4 creation of functional vagina for coitus 5 simple cruciate incision of hymen
c hypo gonado tropic : FSH < 4O due to hypothalamic dys function pituitory dys fun 1 GnRH therapy
General therapy 1 HRT 2 nutrition 3 psychogenic therapy