Puberty Disorders in Girls

Introduction: During puberty, menarche represents the most important event in females. Amenorrhea is defined as the absence of menstruation during puberty. Aim: To evaluate the adolescents with amenorrhea and to analyzed the management of these patients. Material and method: We analyzed 216 patients admitted to the Endocrinology Department over a period of five years, from 2007 to 2012. The study protocol was complex and it consisted in the patients’ history, physical examination and anthropometric measurements. Laboratory evaluation included the measurements of LH, FSH, estradiol, testosterone, DHEA, 17 OH progesterone, TSH, prolactin. Karyotypes, imagistic studies, gynecological and psycological consult were performed in selected cases. Results: Out of 216 adolescents studied with a mean age of 13.8 ± 0.8 years old, 74% of girls were diagnosed with secondary amenorrhea, while the rest had primary amenorrhea. Regarding the etiology of the secondary amenorrhea, 156 patients had secondary amenorrhea caused by stress and 4 cases had mental anorexia. The majority cases of primary amenorrhea were secondary to polycystic ovaries syndrome (60.71%), late form of 21 hydroxylase deficit (7.41%) or Turner syndrome (25%). Therapeutic strategy for patients with secondary amenorrhea consisted in psychotherapy and sedative medication while the treatment of the patients with primary amenorrhea depended of form and etiology. Conclusions and discussions: Amenorrhea can hide behind a symptom complex pathology. A complex evaluation of the patients with irregular menstruation is required. Treatment should be as early as possible.