Etiological diagnosis of amenorrhea in 140 cases

This article reported the study on the etiological diagnosis of amenorrhea in 140 cases.Among 30 cases of primary amenorrhea,5 having abnormality in number or morphology of the sex chromosome showed typical short stature,6 of 46,XY Karyotype,showed normal or thinner and taller stature and underdeveloped breasts.Of the 6 cases with chromosome 46,XY,gonadal malignacy was found in 1 with simple gonadol dysgenesis,and testicular feminization in 5,on whom gonadectomy was done,followed by estrogen replacement.One patient with an appearance similar to Turner’s syndrome had normal karyotype associated with low serum gonadotropins（Gns）,lower serum T3,T4,urine 17KS,170H,and negative LRH test,suggesting gonadal dysgenesis associated with pituitary dysfunction.
Of 110 cases of secondary amenorrhea,55 had no symptomes except for amenorrhea,while the other 55 manifested obesity,hersutism,emaciation,galactorrhea,abdominal mass etc.In both groups,their serum Gn levels were elevated,low,changed without pattern or high in LH/FSH ratio.Further examinations were done,such as laparotomy,X-ray or CT exam on sella tucica,peripheral blood karyotype,diagnostic currettage,ovarian biopsy etc.In the diagnosis of secondary amenorrhea,Gn level has to be taken as a significant parameter,while karyotype is not as important here as in primary amenorrhea.High PRL level suggests the possibility of pituitary tumor,but it’s not a pathognomonic diagnostic indicator.All patients with amenorrhea of uncertain etiology should be follnwed closely.