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  • Title: [Menstrual disorders at puberty].
    Author: Fabre A.
    Journal: Nouv Presse Med; 1974 Jun 08; 3(23):1509-12. PubMed ID: 4845292.
    Abstract:
    This is a complete outlined summary of menstrual disorders of puberty. First diagnostic procedures are suggested, such as history, evaluation of degree of pubertal development, and gynecologic, neurologic, and psychiatric exam, with temperature curve, vaginal smear, basal and stimulated hormone tests, and chromosome studies as required. Common but probably not pathologic complaints include dysmenorrhea (rule out ovarian cyst, endometriosis, congenital malformation); menstrual irregularity (rule out Stein-Levinthal syndrome); menometrorrhagia (rule out Willebrand's syndrome and vaginal or uterine tumor). Primary amenorrhea, if not simply late development, could be due to ovarian dysgenesis, Turner's syndrome, sellar tumor, olfactory-genital syndrome, testicular feminization syndrome, or malformation of the vagina or uterus. Amenorrhea with virilization may be of adrenal or ovarian origin, distinguished by whether urinary ketosteroids are elevated after adrenal inhibition or after ovarian stimulation. Secondary amenorrhea may possibly be related to hypothyroidism, adrenal androgens, pregnancy, or psychogenic causes. If urinary gonadotropins are high, ovarian tumor, primitive ovarian insufficiency, or gonadal dysgenesis may be suspected; of if gonadotropins are low, primitive hypothalamic syndrome, tumor, or iatrogenic causes may be considered as causes of secondary amenorrhea.
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