Amenorrhea.—Amenorrhea is the absence of menstruation. Failure of the menstrual blood to be discharged from the vagina, such as occurs in cases of atresia, is not necessarily amenorrhea; menstruation may have taken place, though the most marked phenomenon of this process, the discharge of blood, is concealed.
The term primary amenorrhea, or emansio mensium, is applied to those cases in which menstruation has never appeared. Secondary amenorrhea, or suppressio mensium, is applied to those cases in which menstruation has ceased after having once been established.
Amenorrhea is due to defective development of the organs of generation; to premature atrophy, such as occurs in superinvolution of the uterus; to lesions, pathological and traumatic; to acute and chronic general diseases; and to psychical disturbances.
Menstruation is often absent during the acute diseases, such as typhoid fever, and it may remain suppressed until the general health is fully restored.
Amenorrhea may also occur in any chronic debilitating condition. It is common in chlorosis, anemia, phthisis, and malaria.
It frequently results from changes of climate and surroundings, and continues until the person becomes adapted to the new environment. It is seen in emigrants from other countries, and in women who move from the country to large cities. It is often caused by overwork, physical and mental, and by insufficient food. It is not uncommon in studious school-girls.
Amenorrhea is sometimes due to the excessive general development of fat, even in young woman who are apparently in good general health.
Amenorrhea is frequently associated with insanity. It may be caused by fright, grief, or anxiety. The fear of pregnancy after illicit coitus sometimes produces it.
In some unusual cases amenorrhea is present without any discoverable cause. The woman may be in perfect general health, and the sexual organs may be well developed, at least so far as can be determined by physical examination.
In amenorrhea there is often a general periodical disturbance that marks the times at which the menstrual bleeding should occur. There may be headache, flashes of heat, nervousness, nausea and vomiting, and a feeling of fulness and pain in the pelvis. Various cutaneous eruptions may occur as the result of amenorrhea, as in other diseases of the genital apparatus.