Talk:Amenorrhea

This article was the subject of a Wiki Education Foundation-supported course assignment, between 2 May 2022 and 3 June 2022. Further details are available on the course page. Student editor(s): Aashakashah (article contribs).

Untitled

Hi Wiki community, We are a group of Middlebury College undergraduate students working on a project for our Introduction to Neuroscience (NSCI 100) course. We will making modifications during the next few weeks on the Amenorrhea page to provide people with more information on this syndrome. Talk to us with any corrections you think we should make! Thanks! — JoshBerlowitz (talk) and Vrodriguez360 (talk)21:26, 11 November 2013 (UTC)

Article Evaluation

Article's content is relevant to the topic. There is enough information for an overview of the topic and the different causes + treatments.

Content is written neutrally. Most content are facts that have been taken from systematic reviews and peer reviewed journals.

Almost all claims have citations. There are some statements that do not have citations, but most these are summary statements at the beginning of subsections, and the information is probably utilized from the next citation listed.

Summary: Currently includes brief overview of amenorrhea and common causes of primary and secondary amenorrhea. Can edit to have shorter more general sentences since full description of different causes of amenorrhea is could later on in the article. Can include etymology information here if needed instead of in a separate subsection.

Classification: Divide this section up into two subsections: primary and secondary amenorrhea. The table has useful information, but I think it makes the article more complicating to read as there are many unfamiliar terms. Third section for functional classification of amenorrhea, which is an older way to classify. Different examples of the conditions in each type can be states within each subsection.

Cause: Current draft has listed many common causes of amenorrhea. Can go into more detail about each different cause, including frequency, age, lab test results, and brief treatment. Diagnosis: Different tests used for diagnosis for amenorrhea. Flow chart of diagram of some sort describing the workup for amenorrhea can be useful here.

Treatment: Overall treatment, as well as treatment based on type of amenorrhea. Also can include specific treatments for common causes of amenorrhea. New treatments that are now more frequently being used outside of clinical trials can also be included here. History: Only states one point about amenorrhea. This subsection can be deleted and information moved to another section such as in causes.

Etymology: Move to summary section.

Can maybe include a section on the normal functioning hormones and pathways in order to better describe where things can differ for a patient to have amenorrhea. Or this can be a part of the classification section.

Prognosis section and section on outcomes of people experiencing amenorrhea can provide information for long term outlook. Aashakashah (talk) 01:02, 15 February 2022 (UTC)

Peer Review NSC 100 Class

Comment 1

This Wiki page provides clear and organized information about the topic. A few areas to improve/expand upon are the hypothalamic section, the drug-induced section. The hypothalamic section provides a great explanation of the cause but the difference between excessive exercise and weight loss creates some confusion. It was difficult to distinguish within the paragraph the difference between the processes behind excessive exercise contributing to amenorrhoea and the processes behind weight loss contributing to amenorrhoea. At the beginning of the paragraph it says there are three causes, however it was hard to separate. Perhaps if the paragraph was formatted into two or three paragraphs so that the processes were separate there would be more clarity. It would also be interesting to see more information about stress as a cause; or at least the hormones involved.

More information in the drug-induced section regarding how drugs, especially contraceptives, cause amenorrhoea would be helpful to this topic. Is it because they alter hormone levels? If so, which hormones? In addition to these sections, a further suggestion for improvement is to define FSH in the initial part of the classification section, as it is pertinent to the information that follows in the table. A quick explanation of FSH and LH and whether they stimulate or inhibit menstruation at the beginning would also be helpful and increase the readability of the following sections. Emmaskyewilkinson (talk) 01:29, 22 November 2013 (UTC)

• Thank you for your detailed response! As far as the differences between causes of Hypothalamic Amenorrhoea, namely the difference between excersise and weight loss-induced symptoms, it is difficult to distinguish the two, since the overall trigger pertains to an insufficient storage of fat, which is needed for hormone production. I will try to make it clear that this divide is still being researched.

In addition, I will attempt to clarify the three main causes of hypothalamic Amenorrhoea, and to expand on effects of stress.

We were more focused on the neurological behavior that takes place in response to physical experiences that would unintentionally trigger amenorrhoea, as it is difficult to consider it a disorder when it is planned by birth control--it seems that talk on this subject would be better placed under a wiki page titled "contraceptives" and then link to amenorrhoea, but thank you for the suggestion.

Lastly, I will try to expand on the FSH and LH explanation, though we have also created internal links for both of these terms, so that the reader can grasp the concepts without being interrupted or overwhelmed on the actual page.

Again, thanks for the feedback.Vrodriguez360 (talk) 16:28, 3 December 2013 (UTC)

Comment 2

It may be helpful to give a short description about oligomenorrheoa just to give a little more background on the topic. You have many internal Wiki links, which is extremely helpful for navigating this topic. Instead of citing the author’s name within the text, you could solely utilize the References sections and link back to them. The use of the chart delineating the hormonal effects is effective and well organized. It would also be interesting to examine the social effects this could have on women’s lives and what this means for trying to conceive and give birth. The etymology could be included in the introduction; it seems unnecessary at the end of the article when a person has already taken the time to learn about this topic. The history could also be included at the beginning. Your Reference section is well-supported. Cmeagher (talk) 16:35, 26 November 2013 (UTC)

• Thanks for your review! As to the author's name, that was not a section that we added, but it is one that we fixed. I see where you are coming from with your comments about the Etymology and History sections. While I think the history section can (and should) be moved to the beginning, I like the etymology section at the end. It's a nice footnote of a section. Your comments about oligomenorrhea are helpful. As a related disorder, it should be addressed in the article. However, I feel that that is sufficiently accomplished in the introduction. Oligomenorrhea is a separate disorder, and has its own Wikipedia page (which is linked to in the introduction). I'm also going to research some social effects because I agree that that could be interesting. Information has been added to address this issue! A whole section, in fact. Thank you for your helpful comments! JoshBerlowitz (talk) 22:15, 30 November 2013 (UTC)

Comment 3

Hi, this article has a lot of useful information. One of the suggestions that I have would be to change the format of some of your in text citations. Rather than putting the authors name in parenthesis, it would be helpful to use superscripts when citing your sources. I also think that it would be useful for you to mention how disorders of the endocrine system can cause amenorrhea. There are also some parts of your article that could be merged together to make the article overall more concise. For example, the paragraphs on diagnosing primary and secondary amenorrhea contain the same type of information and could therefore be merged into one paragraph rather than two. The section on “etymology” probably does not need to have its own paragraph, the etymology can simply be mentioned in the introduction. Alexandraf51895 (talk) 16:37, 26 November 2013 (UTC) — Preceding unsigned comment added by Cmeagher (talk • contribs)

• Thanks for your helpful review! I will try to address all of the points you made. First, I removed some of the in-text author citations that you took issue with. They were redundant because the reference was also in the reference list! As to the section on diagnosis, I am leaving it as two sections. Primary and Secondary Amenorrhea are different enough that diagnosing them is significantly different. There is reason enough (in my opinion) for the sections to be kept separate: the processes are completely different to diagnose one or the other. The etymology was not a section done by us, but I will defend its independence. Etymology of a word does provide some information for the reader, but not so much as to necessitate it being the first thing read by someone who comes to the page for information. I think it's best as an almost-footnote at the bottom of the page. I am looking into what else can be added to provide clarity on how endocrine disorders cause amenorrhea, however, from previous research, I expect that the answer will have to do with changing hormone levels. The endocrine system regulates bodily hormones, and amenorrhea is often caused by hormone-level disruption. For example, an alteration in the LH/FSH ratio or a lack of a critical level of leptin can cause amenorrhea. This information is already present in the article. But I will still look into what else I can add! Thank you for your comments! JoshBerlowitz (talk) 19:17, 30 November 2013 (UTC)

Comment 4

The information on this page is informative and well organized. The chart under the Classification section makes it very easy to understand how the disorders relate to FSH, Primary, and Secondary Amenorrhea. The Hypothamic causes paragraph is very detailed and flows well, but I would add a little more about the combined oral contraceptive pill and the reasons doctors proscribe it. In the second under Diagnosis, I think it would help to add a link to Secondary Sex Characteristics or provide examples to clarify how they impact the diagnosis of Primary Amenorrhea. Vmanjarrez (talk) 18:27, 26 November 2013 (UTC)

• Thanks for your helpful comments! I added an internal link to the page for secondary sex characteristics and provided a couple examples on this page to provide clarity. After looking for more information on oral contraceptives leading to amenorrhea, I have found some information that will improve this article. I did not add reasons for why doctors proscribe "the Pill," because I didn't think it was directly relevant to amenorrhea. The OCOP is the form of birth control that most Americans know as "the Pill" and the reasons for its proscription are addressed in its own Wikipedia article. That said, I did add more to explain the link between OCOP (and other pills) and amenorrhea. So thanks! Doubly addressed! JoshBerlowitz (talk) 18:50, 30 November 2013 (UTC)

Comment 5

Hi Josh and Veronica, Thanks for the thorough job on this topic. You guys did a nice job of taking the neural route for this disorder and dodging a straight peripheral focus. Please make sure that you double check the formatting on your references. User:Midd Intro Neuro —Preceding undated comment added 14:39, 3 December 2013 (UTC)

Anorexia

Does anorexia nervosa really belong in "primary amenorrhea?" It seems to me like it would be secondary. - Cyborg Ninja 18:01, 25 July 2007 (UTC)

You're right, and in fact, it's already mentioned in the Secondary Amenorrhea section. Thanks for pointing this out. --Puellanivis 20:05, 25 July 2007 (UTC)

Amenorrhoea

Um, does this mean that the patient will not be able to reproduce?-- Vintei  talk  21:53, 6 December 2007 (UTC)

A good question, and something that we should address in the article (if not already there). Amenorrhoea can be caused by a number of factors, and each one has a different outcome on reproduction. With Primary Amenorrhea in some cases, such as Müllerian Agenesis, the person still has functional ovaries, but simply no reproductive system. She could not be pregnant herself, nor carry the baby to term by herself, but through surrogacy, she can have a direct-genetic descendant. However, in other cases, such as Gonadal Dysgenesis, the person would not have any functional gonad from which to extract ovaries. Thus, similar to men with Klinefelter's syndrome, any reproductive cell that could be extracted would be entirely unable to germinate given any and all conditions.

Secondary Amenorrhoea is however typically temporary, and can be resolved. The exception is Menopause, where the reproductive system is stopping naturally. Cancers can be put into remission and the patient's menstral cycle should return, horone imbalances can be controlled with medication, and external factors can be removed, such as removal of stress, returning to a healthy weight, and drug-induced amenorrhea can be resolved by taking the person of the drug. If the drug is illegal, or illicit, then that should be no problem, however if removal of the drug would cause a life-threatening situation, it's typically chosen to be the best option to accept the Amenorrhea. --Puellanivis (talk) 19:16, 7 December 2007 (UTC)

Rough sex

Another question that should be addressed as there are many questions across fourms and message boards across the internet... "Can rough or excessive sex cause amenorrhoea?" —Preceding unsigned comment added by Acuraintegralove (talk • contribs) 20:55, 6 March 2008 (UTC)

Urine?

Progesterone will also help the bleeding or dark colored urine from a woman's vagina
Really? Secondary amenorrhoea can cause your bladder to re-route itself to your vagina? *skeptical*
66.167.231.184 (talk) 20:47, 14 September 2008 (UTC)

Breastfeeding

Why is this not mentioned? There's a whole wiki page on Lactational amenorrhea and its not even mentioned as I can see. Breastfeeding releases prolactin that suppresses ovulation and menstruation. — Preceding unsigned comment added by 70.120.206.123 (talk) 03:13, 27 July 2011 (UTC)

Okay, I see it up above but its not in the chart

70.120.206.123 (talk) 03:15, 27 July 2011 (UTC)

Comment 3

Hi, this article has a lot of useful information. One of the suggestions that I have would be to change the format of some of your in text citations. Rather than putting the authors name in parenthesis, it would be helpful to use superscripts when citing your sources. I also think that it would be useful for you to mention how disorders of the endocrine system can cause amenorrhea. There are also some parts of your article that could be merged together to make the article overall more concise. For example, the paragraphs on diagnosing primary and secondary amenorrhea contain the same type of information and could therefore be merged into one paragraph rather than two. The section on “etymology” probably does not need to have its own paragraph, the etymology can simply be mentioned in the introduction. Alexandraf51895 (talk) 16:37, 26 November 2013 (UTC)

Stress

I copied a bit from the diagnosis section to the causes section, and made a new section, stress.

Where does it belong?

Benjamin (talk) 03:13, 19 February 2017 (UTC)

Low body weight

The section #Low body weight should be renamed, perhaps to Low body fat ratio, or just Fat ratio, or some such. My understanding is that it's not about the weight, per se, but about the percentage of fat. Also, a woman who's 150cm (4'11") with an average frame will have a lower body weight than a woman who is 180cm (5'11") and an average frame but is no more likely to suffer from amenorrhea, because it's not about low body weight. Mathglot (talk) 05:58, 10 September 2017 (UTC)

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Sources

• impeforate hymen

Barbara (WVS) ✐  ✉ 09:39, 21 January 2018 (UTC)

Extraneous exercise

Surely "strenuous" exercise is meant here, in section § Low body weight, no? Mathglot (talk) 04:35, 22 October 2023 (UTC)