Amenorrhea: My Practicum Experience With A 35-Year-Old Woman

Introduction

Amenorrhea is a severe condition that can affect different women in different ages. This condition is characterized by a woman missing her periods for a prolonged time say three months. I especially recall the first time that I attended to a patient with this condition. This was during my practicum experience. The patient was a thirty-five-year-old African American woman who had not had her periods for the past four months. She did not complain of having any complications or pain in her body. To get to the bottom of the matter. I conducted a pelvic examination. The examination went on without a hitch. During the exam, I did not find anything wrong with her. The examination was vital as it would help me lower the number of possible causes of her condition.

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The patient had not had any history of sexually transmitted infections. She was in a monogamous marriage with only one sexual partner, her husband. She had two kids, and she was not planning to have another. As a result, she had discussed with her husband about using condoms as a contraceptive, and he agreed. She said that she had not used any other contraceptive option other than the condoms. She was not obese and had a BMI of 21. When I asked her, she said she had not been sick for over ten months, and there were no medications that she was currently taking. Realizing that there were no immediately visible causes of the problem, I requested a test to find the hormonal levels in her blood. As we were waiting for her results, I asked her if some of her relatives had had the conditions. She confessed that her elder sister and her aunt had had the same problems. When the results came back, the results showed that she had low follicle stimulating hormone (FSH) and luteinizing hormone (LH). I diagnosed this to be the cause of her amenorrhea.

After the diagnosis, I had to come up with a treatment plan for the condition that the lady had. FSH is a hormone secreted by the gonadotropic cells in the pituitary gland and is responsible for the reproductive processes in the female body. A deficiency in this hormone results in a decrease in the reproductive functions of the body like the release of the egg from the ovary. If the egg is not released from the ovary, then there will be no menstruation just like in the case of the woman. On further examination of the pituitary gland of the woman, it was found that there was a non-cancerous lump of cells that was inhibiting the production of the hormones. It was imperative that the cells be surgically removed to let the body go back to its normal functions. After receiving consent from the lady and her husband, it was agreed that the best option for her was surgery. The surgery was not complicated, and it took less than an hour. The woman was placed under medication to help improve her production of the hormones and advised to eat food that would help her to heal and to improve her pituitary glands. She was also scheduled to have monthly checkups to ensure that her treatment was on track. When I was leaving my practice, she had recovered and was going on with her life.

References

Fourman, L. T., & Fazeli, P. K. (2015). Neuroendocrine causes of amenorrhea-an update. The Journal of Clinical Endocrinology & Metabolism, 100(3), 812-824.

Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., ... & Warren, M. P. (2017). Functional hypothalamic amenorrhea: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(5), 1413-1439.

Sanders, K. M., Kawwass, J. F., Loucks, T., & Berga, S. L. (2018). Heightened cortisol response to exercise challenge in women with functional hypothalamic amenorrhea. American journal of obstetrics and gynecology, 218(2), 230-e1.