Amenorreah Flashcards
congenital anomalies were there is no uterus
- Mullerian Agenesis
- Complete Androgen insensitivity
Complete androgen insesitivity features
- XY patient
- Female genitalia
- Doesn’t respond to testosterone
Congenital anatomic causes of Amenorreah
- Mullerian Agenesis
- Complete Androgen insensitivity
- Vaginal Septum
- Cervical Atresia
- Imperforate Hymen
Acquired anatomic causes of Amenorreah
- Intrauterine Synechiea (Asherman Syn)
- Cx stenosis
Hypergonadotropic hypogonadism causes of amenorreah
FSH excessive production
inherited:
- Gonadal dysgenesis (turner s)
- Single gene disorders.
acquired:
- infectious
- autoimmune
- iatrogenic
- idiopathic
Eugonadotropic amenorrhea
Inherited:
- PCO
- Non classic congenital adrenal hyperplasia
Acquired:
- Hyperprolactinemia
- Thyroid dis.
- Cushing syn
- acromegaly
- ovarian tumors (steroid producing)
sheehan syn.
severe hmg, shock or hypotension during or before parturition may lead to pospartum pituitary necrosis/infarction.
this results in partial or complete hypopituitarism.
Hypogonadotropic hypogonadism
disorders of the anterior pituitary gland
low FSH
Inherited:
- Pituitary Hypoplasia
Acquired:
- Prolactinoma
- macroadenoma
- mets
- infarction (sheehan syn.)
mode of inheritence of androgen insensitivity
x-linked recessive
no male carriers, if affected-> diseased
Hypogonadotropic hypogonadism
disorders of the hypothalmus
low FSH
Inherited:
- Idiopathic hypogonadotropic hypogonadism
- Kallman syn
Acquired:
- Eating disorders
- Excessive exercise
- stress
what are mullerian structures
- upper part of vagina
- cervix
- uterus
fallopian tubes
Normal Prolactin level
<20 ng/ml in non-preg. women
inc. 10 folds in preg.
best method of imaging of prolactinoma
MRI, esp. if PRL>100
in treating hyperprolacinemia
give dopamine agonist:
- Cabergoline
- Bromocriptine (better if seeking pregnancy)
