Amenorrhea-galactorrhea syndrome is a condition in which a woman experiences both amenorrhea (absence of menstrual periods) and galactorrhea (breast milk production in the absence of pregnancy or lactation).
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Amennorrhea-Galactorrhea Syndrome [MEDNOTES+MINDMAP]
Definition:
- A rare disorder caused by scar tissue formation in the uterus, leading to abnormal function and structure of the uterus
Epidemiology:
- More common in women of reproductive age
- Risk factors include: uterine surgery, dilation and curettage (D&C), uterine infection, uterine trauma
- Prevalence is not well-known due to underdiagnosis and lack of data
Natural history:
- Can cause infertility, miscarriages, and other obstetrical complications
- May lead to emotional and psychological distress for affected individuals
Classification/Types/Stages:
- Classified as primary or secondary, depending on the cause
- Primary: occurs spontaneously without any known cause
- Secondary: caused by uterine surgery, D&C, infection, or trauma
- Stages based on severity:
- Stage 1: minimal scarring, minimal impact on uterine function
- Stage 2: moderate scarring, moderate impact on uterine function
- Stage 3: severe scarring, severe impact on uterine function
- Stage 4: complete obliteration of the uterine cavity
- Can also be classified based on location of scar tissue within the uterus:
- Intramural: within the uterine wall
- Submucosal: beneath the uterine lining
- Subserosal: beneath the outer layer of the uterus
Risk Factors:
- Previous uterine surgery or instrumentation, such as D&C (dilation and curettage), C-section, or abortion
- Previous uterine infection, such as endometritis
- Scar tissue or adhesions in the uterine lining or cervix
- Use of certain contraceptives, such as an IUD (intrauterine device)
- Complications during pregnancy or childbirth, such as placental abruption or uterine rupture
Etiology/Causes:
- Formation of scar tissue or adhesions in the uterine lining or cervix due to uterine surgery or instrumentation, infection, or other trauma
- Abnormal response to inflammation or injury in the uterus
Signs:
- Menstrual abnormalities, such as amenorrhea (absence of periods) or irregular periods
- Infertility or difficulty getting pregnant
- Pelvic pain or discomfort
- Light or absent bleeding during menstruation
Symptoms:
- Abdominal pain or cramping during menstruation
- Fatigue
- Weight gain
- Mood changes or depression
- Difficulty getting pregnant or infertility
Histology/Microscopic Changes
- Scar tissue formation in the uterine cavity
- Thickened endometrial lining
- Absence of menstrual bleeding
Pathology/Pathogenesis
- Causes: uterine surgery (such as c-section, abortion, or D&C), uterine infection, uterine trauma
- Results in adhesions or scar tissue forming between the uterine walls, blocking the menstrual flow and hindering implantation of a fertilized egg
Diagnosis/Laboratory Diagnosis
- Pelvic exam to check for adhesions or scar tissue
- Ultrasound to visualize the uterine cavity
- Hysteroscopy to directly visualize the uterine cavity
- Endometrial biopsy to confirm the presence of scar tissue
Tests Required
- Pelvic exam
- Ultrasound
- Hysteroscopy
- Endometrial biopsy
Associated with/Strongly Associated with:
- Dilation and curettage (D&C) procedure
- Cesarean delivery
- Uterine surgery or trauma
- Infection or inflammation of the uterus
Similar syndromes:
- Adenomyosis
- Endometriosis
- Uterine fibroids
Prevention:
- Avoiding unnecessary uterine procedures or surgeries
- Proper care and treatment of uterine infections or inflammation
- Careful management of pregnancy and childbirth
Treatment:
- Hormonal therapy to stimulate the regrowth of the endometrial lining
- Surgery to remove scar tissue and reconstruct the uterus
- Assisted reproduction techniques, such as in vitro fertilization, to bypass the damaged uterine lining
- Adoption or surrogacy as alternative options for starting a family
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