Diagnosis of ovarian amenorrhea

Normal women have a cycle of follicle development and maturation, and their reproductive tract is unobstructed, followed by menstruation. Ovarian amenorrhea is when there is no egg or follicle development and maturation in the ovaries due to congenital factors or multiple acquired factors, and no menstruation.

(1) Primary ovarian amenorrhea: ① Congenital ovarian dysgenesis: abnormal sex chromosomes. ② Ovarian resistance syndrome: There are primordial follicles in the ovaries, but they do not respond to gonadotropins, there are no developed follicles, and the ovaries show focal or diffuse transparent degeneration. Clinical manifestations include primary amenorrhea, poor development of secondary sexual characteristics, poor breast development, and little or no pubic and axillary hair. Hormone measurement shows low estrogen levels, but high gonadotropins, and no response to gonadotropins.

(2) Secondary ovarian amenorrhea: ① Premature ovarian failure: Ovarian failure caused by ovarian follicle exhaustion or heterologous damage before the age of 40 in women is called premature ovarian failure, which is manifested by regular menstruation, secondary amenorrhea, and perimenopausal symptoms. ② Functional ovarian tumors: seen in ovarian supporting-interstitial cell tumors that secrete androgens, and ovarian granulosa-theca cell tumors that secrete estrogen. ③ Polycystic ovary syndrome: characterized by long-term anovulation and hyperandrogenemia, clinical manifestations include amenorrhea, infertility, obesity, hirsutism, or accompanied by acanthosis nigricans.