1. What do you mean by amenorrhea? Absence of menstruation includes never having had a period and not having had one for some time. Professionally, amenorrhea is when menstruation never comes or stops abnormally. Amenorrhea in physiological cases refers to the absence of menstruation before puberty, during pregnancy, lactation and after menopause. There are two types of pathological amenorrhea: primary amenorrhea and secondary amenorrhea. Primary amenorrhea refers to the absence of menstruation in women older than 16 years of age or older than 14 years of age, and the absence of secondary sexual characteristics (e.g., breast development, appearance of axillary and pubic hair). Secondary amenorrhea is defined as the cessation of menstruation for 6 months after the establishment of normal menstruation, or the cessation of menstruation for more than 3 cycles according to one’s original menstrual cycle. 2.How to diagnose amenorrhea? It is more complicated and requires a series of clinical and endocrine tests to obtain a clear diagnosis. The causes of amenorrhea are classified according to the location of the lesion: (1) uterine amenorrhea; (2) ovarian amenorrhea; (3) pituitary amenorrhea; (4) hypothalamic amenorrhea. 3.How is amenorrhea caused? The causes of primary amenorrhea include chromosomal abnormalities, gonadal dysgenesis, malleolar dysgenesis and hypothalamic abnormalities. It should be noted that if it is one of the hermaphroditism and there is cryptorchidism in the abdominal cavity, it should be detected and surgically removed in time, otherwise there is a possibility of cancer. The causes of secondary amenorrhea are: polycystic ovary syndrome, hyperprolactinemia and premature ovarian failure, etc. Hypothalamic amenorrhea is the most common. 4.How to prevent amenorrhea? Mental relaxation, maintaining a moderate weight (not thin, not fat), proper exercise, and avoiding overexertion. Conventional treatment As the causes of amenorrhea are complex, the treatment varies. For patients with ovulation disorders and need to get pregnant, ovulation promotion treatment; for patients with ovulation disorders but do not need to get pregnant, artificial cycles, oral contraceptives, and post-half cycle progesterone treatment; for patients with hyperprolactinemia, pharmacological prolactin-lowering treatment; for uterine cavity adhesions, hysteroscopic treatment; for pituitary tumors, pharmacological or surgical treatment. For chromosomal abnormalities, only symptomatic treatment is available on a case-by-case basis. Preparation for medical treatment After menstruation, women who have had their first period and have had sex can first rule out the possibility of pregnancy on their own. You can use a pregnancy test to monitor your urine. If you are not pregnant, you should consider pathological secondary amenorrhea. You will need to go to the hospital. Examination methods: Primary amenorrhea: First, external genital and breast examinations, ultrasound examination of the uterus and chromosomal examination. Secondary amenorrhea: Emphasis on sex hormone examination. The most common test for secondary amenorrhea is the “progesterone test”. If there is bleeding after progesterone, it suggests that there is some estrogen in the body. If there is no bleeding after progesterone, two conditions are considered (again, pregnancy should be ruled out): (1) uterine pathology; (2) low estrogen levels in the body. The cause can be premature ovarian failure or central amenorrhea (lesions in the hypothalamus or pituitary gland); in patients who do not bleed, the doctor will perform another “estrogen and progesterone test” and rule out uterine amenorrhea if there is bleeding after the medication; if there is still no bleeding, consider uterine amenorrhea. It may be endometrial tuberculosis, uterine adhesions, etc. Hysteroscopy, diagnostic endometrial curettage, hysterosalpingogram, etc. can be done to find the cause. Precautions after treatment Those who are treated with endocrine therapy should figure out the more complicated methods of medication and precautions. Regular follow-up examinations should be performed according to the doctor’s prescription. The most common part of the question: Should amenorrhea be treated? Answer: Give an example of secondary amenorrhea. In case of polycystic ovary syndrome, with long-term non-ovulation and continuous estrogen stimulation of endometrial hyperplasia without progesterone resistance, the possibility of endometrial carcinoma increases. To give an example of primary amenorrhea, if there is a cryptorchid in the abdomen, it should be detected and surgically removed in time, otherwise there is a possibility of cancer. Therefore, amenorrhea should be diagnosed and treated in a hospital.