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Herman-Giddens, M.E., Slora, E.J., Wasserman, R.C., Bourdony, C.J., Bhapkar, M.V., Koch, G.G., et al. (1997) Secondary sexual characteristics and menses in young girls seen in office practice: A study from the pediatric research in office settings network. Pediatrics, 99, 505-512. doi:10.1542/peds.99.4.505

has been cited by the following article:

• TITLE: Primary amenorrhea with transverse vaginal septum and scant hematocolpos: A case report

  AUTHORS: Lori Homa, Semara Thomas, Joseph Sanfilippo

  KEYWORDS: Amenorrhea; Hematocolpos; Distal Obstruction; Hypothalamic Dysfunction

  JOURNAL NAME: Open Journal of Pediatrics, Vol.2 No.1, March 21, 2012

  ABSTRACT: Background: A genital outflow tract obstruction is an uncommon cause of primary amenorrhea. If ovulation occurs, menstrual bleeding is prevented. Patients typically present with abdominal/pelvic pain due to hematocolpos. Absence of significant hematocolpos could indicate a secondary source of primary amenorrhea and be challenging to the clinical diagnosis. Case: 17 year-old patient with primary amenorrhea, appropriate Tanner staging secondary sex characteristics, and transverse vaginal septum presents with virtual absence of hematocolpos. After vaginal septum resection, the patient began menstruating, although only evidenced by two cycles of vaginal spotting. Conclusion: Significant hematocolpos is an expected sequella of distal outlet obstruction when collated with secondary sexual characteristics. Absence of such along with suboptimal return of menstruation reflects pathophysiology which may be attributed to a coexistent disorder of the hypothalamus or higher central nervous system function.