Resumo

SEPULVEDA-AGUDELO, Janer; ALARCON-NIVIA, Miguel Ángel  e  JAIMES-CARVAJAL, Hermes. Primary amenorrea. Rev Colomb Obstet Ginecol [online]. 2009, vol.60, n.1, pp.57-67. ISSN 0034-7434.

Objective: this is a detailed review of primary amenorrhea using Mashchak CA et al. classification according to the presence or absence of breast development and the presence or absence of uterus as being the most useful approach for managing patients suffering from this problem. Method: Medline and Ovid databases were searched for papers published in English using the following keywords: amenorrhea, primary amenorrhea, menstrual disorder, Turner syndrome, Kallmann syndrome, Prader-Willisyndrome, hypogonadotropic hypogonadism. This information was classified to support this review by making summaries for analysis. Results: primary amenorrhea can be caused by many alterations affecting the Mullerian structures, gonads, pituitary gland, hypothalamus, thyroid, adrenals or hormonal dysfunction; such anomalies may be congenital due to genetic or chromosomal defects or acquired. It is thus important that this problem is specifically diagnosed to enable a suitable therapeutic approach to be adopted for minimising the consequences of this disease. Conclusions: many diseases cause this problem, so diagnosing and treating patients suffering from primary amenorrhea must be individualised; however, some general questions needing specific answers are raised by all patients or their families. These questions are related to menstruation and spontaneous menstrual cycles, subsequent fertility, sexuality and the possibility of coitus with satisfactory vaginal penetration.

Palavras-chave : amenorrhea; primary amenorrhea; menstrual disorder; Turner syndrome; Kallmann syndrome; Prader-Willi syndrome; hypogonadotropic-hypogonadism.

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