2 - Amenorrhoea Flashcards
name 3 potential reasons for amenorrhoea?
problems with -
1) regulating hormones
2) ovarian function
3) uterus/ outflow tract
what is hypothalamic/ pituitary (HORMONAL) cause of amenorrhoea?
hypogonadotropic hypogonadism
what is hypogonadotropic hypogonadism?
Low FSH, LH
High Prolactin
hormonal causes - functional?
excessive weight loss/gain
over-exercising
stress
hormonal causes - chronic conditions?
diabetes
sarcoidosis
renal
TB
hormonal causes - intracranial space-occupying lesions?
prolactinoma
tumours
cysts
hormonal causes - infection/ trauma?
meningitis
intracranial bleed
Sheehan’s
hormonal causes - drugs?
glucocorticoids
anabolics steroids
opiates
hormonal causes - genetic?
Kallmann’s Syndrome (GnRH deficiency)
what is hypergonadotropic hypogonadism?
ovarian cause of amenorrhoea -
High/ normal FSH and LH
ovarian causes - genetic?
Turner’s syndrome (46X)
Fragile X
ovarian causes - ageing?
steep decrease in ovarian function >35 years
ovarian causes - POI/ POF?
1y ovarian insufficiency/ premature ovarian failure
ovarian causes - chronic illnesses?
autoimmune diseases
ovarian causes - cancer?
radio/ chemo- therapy
ovarian causes - infection?
TB
mumps oophoritis
uterus/ outflow causes - congenital?
MRKH syndrome
absent uterus/ vagina
transverse vaginal septum
imperforate hymen
androgen insensitivity hormone
uterus/ outflow causes - iatrogenic?
Asherman Syndrome
Radiotherapy (cervix/ pelvis)
management of amenorhoea? (3)
lifestyle changes
optimise control of medical conditions
stop drugs/ switch to alternatives
prolactinoma - management?
medical treatment
intracranial SOL - management?
surgical treatment
vaginal anomalies?
surgical treatment
uterine adhesions?
surgical division hysteroscopic
fertility management?
fertility preservation before therapy
IVF with own/ donor’s eggs
