Bone Mineral Density in Primary and Secondary Amenorrhea

WICHARN CHOKTANASIRI, M.D.*, ARAM ROJANASAKUL, M.D.*, RAJATA RAJATANAVIN,M.D.**

Affiliation : **Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

AbstractAmenorrhea in young women is one of the best clinical indicators for estrogen defi- ciency, except in the presence of gynecological structural pathology. This study aimed at in- vestigating bone mineral density (BMD) in patients with primary and secondary amenorrhea. Thirty-six patients were enrolled in the study, seven with primary amenorrhea (mean age 24.3± 4.5 yrs.) and twenty-nine with secondary amenorrhea (mean age 31.1±6.9 yrs.). Eighteen regularly menstruating women (mean age 31.8±3.7 yrs.) served as controls. BMD was measured at lumbar spine, femoral neck, Ward's triangle and trochanter.
Results : BMD was significantly decreased in both primary and secondary hypoestrogen amenorrheic patients. Primary amenorrheic patients were more severely affected with a BMD mean Z score below 80 per cent (osteopenia) at all sites measured. The age of primary amenorrheic women also strongly correlated with degree of demineralization. This should emphasize the importance of early diagnosis and treatment of young amenorrheic patients.

Keywords : Primary and Secondary Amenonorrhea, Bone Mineral Density

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