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      Causes of amenorrhea in Korea: Experience of a single large center

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          Abstract

          Objective

          To investigate the causes of amenorrhea in Korean women.

          Methods

          Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary.

          Results

          Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-Küster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080).

          Conclusion

          In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women.

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          Most cited references14

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          Clinical practice. Functional hypothalamic amenorrhea.

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            Current evaluation of amenorrhea.

            (2008)
            Amenorrhea is absence or abnormal cessation of the menses. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively.
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              Premature ovarian failure.

              Premature ovarian failure is the term usually used to describe women aged younger than 40 years who present with amenorrhea, hypergonadotropinism, and hypoestrogenism. Such women may ovulate and even conceive after the diagnosis is made, so it may be more appropriate to refer to these patients as having "primary ovarian insufficiency," or alternatively, as having "hypergonadotropic hypogonadism" or "primary hypogonadism." The clinical presentation is diverse, and several different disorders can lead to premature ovarian failure. Affected women should be investigated for premutations of the FMR1 gene (causing fragile X syndrome in its fullest form) and for adrenal antibodies. Thyroiditis is the most frequent autoimmune disorder associated with premature ovarian failure and should be ruled out as well. Osteopenia is increased in women with premature ovarian failure, and measures to prevent accelerated bone loss are warranted. Hormone therapy (HT) should be provided to eliminate symptoms of estrogen deficiency and help prevent osteopenia, but will not necessarily (and inexplicably) prevent pregnancy in the 5-10% of women who conceive spontaneously after the diagnosis is made. There are no data indicating that these young women are at increased risk of side effects from HT. If pregnancy is desired, use of donor oocytes with in vitro fertilization is most likely to result in pregnancy.
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                Author and article information

                Journal
                Clin Exp Reprod Med
                Clin Exp Reprod Med
                CERM
                Clinical and Experimental Reproductive Medicine
                The Korean Society for Reproductive Medicine
                2233-8233
                2233-8241
                March 2014
                14 March 2014
                : 41
                : 1
                : 29-32
                Affiliations
                Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
                Author notes
                Corresponding author: Hee-Dong Chae. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3649, Fax: +82-2-476-7331, hdchae@ 123456amc.seoul.kr
                Article
                10.5653/cerm.2014.41.1.29
                3968254
                24693495
                80edaad5-0173-4235-a1e0-692a48f937d8
                Copyright © 2014. The Korean Society for Reproductive Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 July 2013
                : 09 September 2013
                : 04 January 2014
                Categories
                Original Article

                Obstetrics & Gynecology
                amenorrhea,gonadal dysgenesis,polycystic ovary syndrome,causes
                Obstetrics & Gynecology
                amenorrhea, gonadal dysgenesis, polycystic ovary syndrome, causes

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