Primary Amenorrhea: Analysis of 108 Cases

Abstract

ABSTRACT Primary amenorrhea is defined as the absence of menses in females by the age of 14 years in the absence of secondary sex characteristics or the absence of periods by the age of 16 years regardless of appearance of secondary sex characters. A total of 108 cases of primary amenorrhea were referred to gynecological out-patient department of BIRDEM Hospital, Bangladesh between July 1995 to July 2008. These patients were studied with the aim to find out the cause of amenorrhea. After taking the detailed history, physical examinations and necessary investigations, patients were subjected to laparoscopic evaluation. The study highlights the role of transabdominal sonography in the work up of these cases and compare those with laparoscopic findings. About 69.4% of primary amenorrhoea were due to mullerian dysgenesis; 19.4% due to gonadal dysgenesis; 2.7% due to male pseudohermaphroditism with virilization; 2.7% due to genital tuberculosis and only one case was due to testicular feminization syndrome. Sonographic findings differ from laparoscopic findings in many cases. It can be observed that for optimal evaluation of primary amenorrhea, laparoscopy is the key tool for diagnosis.