Diagnosis of functional hypothalamic amenorrhea

The diagnostic process of functional hypothalamic amenorrhea is to find the cause of amenorrhea and determine at which stage amenorrhea occurs. The following should be noted in the diagnosis:

Medical history

The main questions asked are menstrual history, age at menarche, menstrual cycle, etc., to determine whether it is primary amenorrhea or secondary amenorrhea, which is very important for analyzing the cause of amenorrhea; it is also necessary to understand whether there are congenital defects or other diseases, medication history and response to drug treatment, etc.; ask whether there were any triggers that caused amenorrhea before the onset of the disease, such as mental factors, environmental changes or other diseases.

Physical examination

Attention should be paid to the overall condition, whether the development is normal and whether there are any deformities; whether the height and weight are within the normal range, and the proportions of the limbs and trunk; intelligence, nutrition and health status; check the development of secondary sexual characteristics such as breast development, hair distribution, and whether there is milk secretion; gynecological examinations should pay attention to the development of the internal and external genitalia, and whether there are any defects, deformities or tumors.

Ovarian function test

Estrogen makes the cervical mucus thin, stringy, and has fern-like crystals. The more obvious and coarser the fern-like crystals are, the more significant the estrogen effect is. If rows of ellipsoids are seen on the smear, it indicates that the cervical mucus has been affected by progesterone in addition to the estrogen effect.

Radioimmunoassay of estradiol, progesterone and testosterone: if the concentration of estrogen and progesterone is low, it indicates abnormal ovarian function or failure. If the testosterone value is high, it indicates the possibility of polycystic ovary syndrome, ovarian masculinization tumor or testicular feminization.

Hysteroscopy

Iodine, a high-density substance with a high atomic number, is injected into the uterine cavity through the cervical canal, forming a clear artificial contrast with the surrounding tissues under X-ray film, making the lumen visible, thereby understanding the situation inside the uterus and fallopian tube cavity.