Medical history (history of illness) represents an important component in the diagnosis of oligomenorrhea. Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). When was your last menstrual period? What is the cycle length* (from the first day … Oligomenorrhea: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Laurence-Moon-Biedl-Bardet syndrome (LMBBS) – rare genetic disorder with autosomal recessive inheritance; differentiated by clinical symptoms into: Laurence-Moon syndrome (without polydactyly, i.e., without the appearance of supernumerary fingers or toes, and obesity, but with paraplegia (paraplegia) and muscle hypotonia/reduced muscle tone) and Bardet-Biedl syndrome (with polydactyly, obesity and peculiarities … Oligomenorrhea: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by oligomenorrhea: Neoplasms – Tumor diseases (C00-D48). Endometrial cancer (cancer of the uterus) – chronic anovulation (failure to ovulate) increases the long-term risk of endometrial hyperplasia (thickening of the lining of the uterus) and endometrial cancer. Psyche – Nervous System (F00-F99; G00-G99). … Oligomenorrhea: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes [due todifferential diagnosis of hyperandrogenemia (acne; alopecia androgentica/plant-related hair loss)] Abdominal wall and inguinal region (groin area). Gynecological examination Inspection Vulva (external, primary female sexual … Oligomenorrhea: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count HCG (human chorionic gonadotropin) determination – to rule out pregnancy. FSH (follicle-stimulating hormone). LH (luteinizing hormone) Prolactin TSH (thyroid-stimulating hormone) Testosterone 17-Beta-estradiol Progesertone Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential … Oligomenorrhea: Test and Diagnosis
Therapeutic target Normalization of the cycle interval Therapy recommendations Treatment depending on the causative disorder. The therapy recommendations in this framework refer only to hormonal therapy options for: Contraceptive desire (contraception: estrogen-progestin combinations/anti-baby pill). Chronic anovulation (failure to ovulate) and desire to normalize the cycle interval (progestin monopreparations, oral). Estrogen deficiency Hyperandrogenemia (excess male sex … Oligomenorrhea: Drug Therapy
Obligate medical device diagnostics. Vaginal ultrasonography (ultrasound examination using an ultrasound probe inserted into the vagina) – to assess the genital organs. Abdominal sonography (ultrasound examination of the abdominal organs) – mainly to assess the kidneys, adrenal glands and ovaries (ovaries). Optional medical device diagnostics – depending on the results of the history, physical examination, … Oligomenorrhea: Diagnostic Tests
To prevent oligomenorrhea, attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Alcohol Drug use Amphetamines (indirect sympathomimetic). Heroin LSD (lysergic acid diethylamide/lysergide) Physical activity Competitive sports Psycho-social situation Psychosocial stress Overweight (BMI ≥ 25; obesity). Other risk factors Lactation period (breastfeeding phase)
The following symptoms and complaints may indicate oligomenorrhea: Leading symptom Oligomenorrhea – the interval between bleeding is greater than 35 days and less than 90 days, i.e. bleeding occurs too infrequently Secondary symptoms Hypomenorrhea (the bleeding of the weak; occurrence: frequent). Note: Ovulation (ovulation) is possible and therefore the onset of pregnancy.
Pathogenesis (development of disease) In oligomenorrhea, the interval between bleeding is greater than 31 days, that is, bleeding occurs too infrequently.Follicle maturation disorder (egg maturation disorder) is present, which is usually accompanied by corpus luteum insufficiency (corpus luteum weakness) or, if necessary, leads to anovulation (failure to ovulate). Etiology (causes) Biographic causes Genetic burden from … Oligomenorrhea: Causes
General measures Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for … Oligomenorrhea: Therapy
