Division of Pediatric - Adolescent Gynecology and Reconstructive Surgery, 2nd Department of Obstetrics and Gynecology, University of Athens, Medical School, Aretaieion Hospital, Athens, Greece.
Ann N Y Acad Sci. 2010 Sep;1205:23-32. doi: 10.1111/j.1749-6632.2010.05669.x.
During the first years of menstruation it is not rare for a girl to present with an irregular menstrual pattern. The complete absence or cessation of menses, which is defined as amenorrhea, requires careful evaluation and management. It is divided into primary and secondary types that describe the occurrence of amenorrhea before and after menarche, respectively. The list of causes is long and includes anatomical or functional anomalies of the genital tract, hormonal disorders, and multifactorial reasons. The most common causes are hypothalamic amenorrhea, polycystic ovarian syndrome, hyperprolactinemia, and ovarian failure. A thorough medical history and careful clinical examination of the young girl is absolutely essential. The distinction between primary and secondary amenorrhea, together with the presence, or not, of secondary sexual characteristic development will guide the physician to the differential diagnosis of amenorrhea. Essential laboratory examinations include follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin measurements; while in the presence of acne or hirsutism, androgen levels should also be measured. Management should focus on the restoration of ovulatory cycles and the prevention of short- and long-term consequences of hormonal imbalance.
在初潮的头几年，女孩的月经模式不规律并不罕见。完全没有月经或停经，即闭经，需要仔细评估和管理。它分为原发性和继发性两种类型，分别描述闭经发生在初潮之前和之后。其病因繁多，包括生殖道的解剖或功能异常、激素紊乱以及多种因素。最常见的原因是下丘脑性闭经、多囊卵巢综合征、高催乳素血症和卵巢功能衰竭。对年轻女孩进行全面的病史采集和仔细的临床检查是绝对必要的。原发性和继发性闭经的区别，以及是否存在第二性征发育，将指导医生进行闭经的鉴别诊断。基本的实验室检查包括卵泡刺激素（FSH）、黄体生成素（LH）、促甲状腺激素（TSH）和催乳素测量；而在存在痤疮或多毛症的情况下，也应测量雄激素水平。治疗应侧重于恢复排卵周期，并预防激素失衡的短期和长期后果。
