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“Exploring the Complexities of Secondary Amenorrhea: A Case Study of Justina”
Justina
Amenorrhea, defined as the absence or abnormal cessation of menstrual bleeding, is a relatively common problem among adolescent and young females. The prevalence of amenorrhea not due to pregnancy, lactation, or menopause is approximately 3 to 4%. Primary amenorrhea is the absence of menarche by age 16 years with normal growth and development of secondary sexual characteristics, or by 14 years in the absence of normal growth or development of secondary sexual characteristics. Secondary amenorrhea is the absence of normal menstruation for the equivalent length of time of at least three previous cycle intervals or 6 months of amenorrhea (Teo & Ong, 2021). This patient has the issue of secondary amenorrhea and wasn’t pregnant. Many young women had same issue that lasted 3- 6 months.
Secondary amenorrhea has a wide range of differential diagnoses, and determination of the underlying cause requires prompt assessment with thorough history, focused examination and often specialist referral (Thwaites et al, 2021). Patient refused the progestins prescribed to her which will initiate a menstrual cycle. Patient was also crying which is something the Nurse Practitioner should find out the reason for crying. This patient may have a strong religion that forbids her from taking birth control, so NP should find out about that and prescribe alternative treatment for her or a referral to gynecologist to get details on the reason she has amenorrhea. NP should sit with patient and allow her to tell her story, probably there’s family health history related to patient’s problem.
References
Teo, S. Y., & Ong, C. L. (2021). A systematic approach to imaging the pelvis in amenorrhea. Abdominal Radiology, 46(7), 3326-3341. Doi:https://doi.org/10.1007/s00261-021-02961-9
Thwaites, A., Westwick, R., & Logan, K. (2021). Secondary amenorrhoea – a consultation. BMJ Sexual & Reproductibcive Health, 47(1), 75-77. Doi:https://doi.org/10.1136/bmjsrh-2020-200600
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