menstruation, absent…

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absence of menstruation, amenorrhea, primary amenorrhea, secondary amenorrhea, missed periods, lack of menses, periods, missed, amenorrhea, absence of menstrual flow primary, menstruation fails to begin, age 16, secondary, menstruation begins, appropriate age, later ceases, in the absence of normal causes, pregnancy, lactation, menopause, many perfectly normal females begin to menstruate later than most, median age is 12.8, pregnancy, the first thought, a period is missed, having a late period, incidence of primary amenorrhea, in the united states is less than 1%, incidence of secondary amenorrhea, due to some cause other than pregnancy, 4%, in the general population, increased risk is associated, extreme, prolonged exercise, adequate conditioning, body fat content less than 15% to 17%, extreme obesity, taking hormonal supplements, symptoms associated, amenorrhea depend on the cause, headache, galactorrhea, breasts produce milk, woman who is not pregnant, breast-feeding an infant, visual loss, in rare cases of pituitary tumor, marked weight gain, weight loss, dry vagina, increased hair growth, "male" pattern, hirsutism, voice changes, breast size changes, primary amenorrhea, normal delay of onset, up to age 16, lack of an opening, in the membrane, entrance, the vagina, hymen, drastic weight reduction, congenital abnormalities, the genital system, chromosomal abnormalities, extreme obesity, secondary amenorrhea, pregnancy, anxiety over pregnancy, a missed period, thereby increasing the anxiety further, drastic weight reduction, vigorous athletics, obesity, emotional distress, menopause, women over age 45, endocrine disorders thyroid disease, pituitary disease/tumor, drugs busulfan, chlorambucil, cyclophosphamide, oral contraceptives, phenothiazines, non-oral contraceptives, norplant, depo-provera, dilation, curettage, d, c, treatment depends on the cause, amenorrhea, normal delay of menstruation onset, have patience, age 16, missed period, pregnancy, consult obstetrician to confirm pregnancy, missed period, drastic weight loss, obesity, proper diet, missed period resulting, excessive exercise, use moderation, cut back to a more conservative program, no satisfactory explanation, missed period, medical history, a physical examination performed, a complete health history, a menstrual history, questions, menstrual history, a woman presently, menstruating age range, over 12, under 55, sexually active, use birth control, quality, was the previous menstrual period a normal amount, the menses absent, decreased, have regular periods, time pattern, was last menstrual period, at what age did have first menstrual period, have ever had normal periods, aggravating factors, what medications, take, how much, exercise, breast tenderness, morning nausea, vomiting, a headache, a nipple discharge, not breast feeding, vision loss, change in vision, an unintentional weight gain, an unintentional weight loss, vaginal dryness, hair growth, male pattern, voice changes, in the breast size, excessive anxiety, a physical examination, a pelvic examination, in patients, secondary amenorrhea, physical, pelvic examinations must rule out pregnancy, diagnostic testing begins, patient encouraged to discuss her fears, referred, psychological counseling, diagnostic tests, endometrial biopsy, progestin withdrawal, prolactin level, serum hormone levels testosterone levels, thyroid function studies, pregnancy test, serum hcg, fsh, follicle stimulating hormone level, lh, luteinizing hormone level, tsh, thyroid stimulating hormone, thyroid function tests, karyotype to rule out, y chromosome abnormality, ct scan, the head done, a pituitary tumor is suspected, treatment depends on the cause, the amenorrhea, another systemic disorder, normal menstrual function, returns, primary disorder is treated, primary disorder is hypothyroidism, amenorrhea, cured, the thyroid disorder is treated, thyroid supplements, pituitary tumors, bromocriptine, a drug that inhibits prolactin secretion, surgery removal, suggested, radiation therapy, reserved, situations where other medical, surgical treatment regimens, not successful, a progestin challenge used, a course of treatment, in this test, daily estrogen supplements, given in conjunction, intermittent progestin, 10 to 14 days per month every 1 to 3 months, hormonal supplements, commonly utilized, not bleed in response, progestin challenge test, women who bleed in response, progestin challenge test, anovulatory, not menstruate, not ovulate, common cause of amenorrhea is treated by inducing ovulation, medication clomiphene citrate, clomid, but only patient desires pregnancy, in patients, no immediate plan, pregnancy, oral contraceptive pills, prescribed to induce cyclic menstruation, prevent uncontrolled growth, the endometrial lining, young women, primary amenorrhea, found to be, developmental abnormalities, require hormonal supplementation, surgery, in any case, psychosocial support, counseling, the patient, family is necessary to address specific concerns, provide guidance regarding anticipated sexual development.