[青春期女孩月经失调的原因——一项回顾性研究]

[Causes of menstrual disorders in adolescent girls--a retrospective study].

作者信息

Bieniasz Jolanta, Zak Teresa, Laskowska-Zietek Agnieszka, Noczyńska Anna

机构信息

Klinika Endokrynologii i Diabetologii Wieku Rozwojowego AM we Wrocławiu, Wrocław.

出版信息

Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2006;12(3):205-10.

PMID:17020657

Abstract

INTRODUCTION

Adolescent girls often visit the outpatient endocrinological clinic because of menstrual disorders. The problem arises whether to recognize the menstrual cycle irregularity as a physiology of the adolescence or to initiate diagnostic procedures to exclude pathology. Although irregular menses during first 3 years after menarche are usually symptoms of hypothalamus-pituitary-ovary axis immaturity, it does not exclude disorders to be subject of diagnosis and treatment. THE AIM OF THE STUDY was to evaluate causes of menstrual disorders in adolescent girls, who visited the outpatient clinic of the Department of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, between 2001-2005.

MATERIAL AND METHODS

The study comprised 76 patients, who visited the outpatient endocrinological clinic because of menstrual disorders. Only the girls at least 2 years after menarche or with amenorrhoea primaria were included. The following parameters were analyzed: age, age of menarche, height and body mass, BMI, evidences of androgen excess, hormone levels, gynecological and ultrasound examination.

RESULTS

Average age in the examined group was 16.2 years (min 12.5, max 20), average age of menarche was 12.5 years. Evidence of androgens excess were found in 48 patients (63.2%). The girls were coming to the clinic most often because of rare menses, most rarely because of primary lack of menstruation. Depending on the type of disorders they were divided into five groups: group I--amenorrhoea primaria--4 patients (5.3%), group II--amenorrhoea secundaria--14 patients (18.4%), group III--oligomenorrhoea--38 patients (50%), group IV--polymenorhea--8 patients (10.5%), group V--mixed disorders--12 patients (15.8%). The causes of menstrual disorders depended on the group.

CONCLUSIONS

Menstruation cycles irregularity in the first years after menarche may be a symptom of pathology demanding diagnosis and treatment. 2. PCO should be taken into consideration as a frequent cause of menstrual disorders in adolescent girls.

摘要

引言

青春期女孩常因月经紊乱前往门诊内分泌科就诊。问题在于，是将月经周期不规律视为青春期的一种生理现象，还是启动诊断程序以排除病理情况。尽管初潮后头3年月经不规律通常是下丘脑 - 垂体 - 卵巢轴不成熟的症状，但这并不排除这些紊乱情况需要进行诊断和治疗。本研究的目的是评估2001年至2005年间在弗罗茨瓦夫医科大学儿童与青少年内分泌与糖尿病科门诊就诊的青春期女孩月经紊乱的原因。

材料与方法

该研究包括76例因月经紊乱前往门诊内分泌科就诊的患者。仅纳入初潮至少2年或原发性闭经的女孩。分析了以下参数：年龄、初潮年龄、身高和体重、体重指数、雄激素过多的证据、激素水平、妇科检查和超声检查。

结果

被检查组的平均年龄为16.2岁（最小12.5岁，最大20岁），平均初潮年龄为12.5岁。48例患者（63.2%）发现有雄激素过多的证据。女孩前往诊所就诊最常见的原因是月经稀发，最罕见的原因是原发性闭经。根据紊乱类型，她们被分为五组：第一组——原发性闭经——4例患者（5.3%），第二组——继发性闭经——14例患者（18.4%），第三组——月经过少——38例患者（50%），第四组——月经频发——8例患者（10.5%），第五组——混合性紊乱——12例患者（15.8%）。月经紊乱的原因因组而异。