Amenorreias Flashcards
What is primary amenorrhea?
Absence of menstruation
- Age 13 without secondary sexual characteristics
- Age 15 with secondary sexual characteristics,
*or 3 years after telarche.
Telarche refers to the onset of breast development.
What are the main causes of primary amenorrhea?
- Disgenesia gonadal 50%
- Causa hipotalâmica 20%
- Agenesia Mulleriana 15%
- Septo vaginal ou Himen imperfurado 5%
- Doença Hipofisiária 5%
These percentages indicate the likelihood of each condition being the cause of primary amenorrhea.
Amenorreia primaria + dor pelvica cronica. Provavel etiologia?
Criptomenorreia - ALterações anatomicas obstrutivas
*Agenesia cervical, himen imperfurado, septo vaginal transverso…
Cryptomenorrhea is a condition where menstrual blood cannot exit the body due to obstruction.
Niveis d eFSH que indicam hipogonadismo
< 5
This condition can be due to delays in pubertal development or central causes.
Sindrome de Swyer. No que consiste?
Masculino do turner.
46XY + disgenesia gonadal
*gonadas hipoplasicas (masculinas) + fenotipo feminino
Turner syndrome is characterized by various physical features and medical conditions.
What are the symptoms of Turner syndrome?
- Low stature
- Absence of breasts
- Amenorrhea
- Webbed neck
- Cognitive deficits
- Renal anomalies
- Streak ovaries
- Aortic coarctation
Some patients may have a mosaic karyotype.
What is the management for Swyer syndrome?
- Initiate hormone therapy during adolescence (Estradiol 0.5mg to 2mg/day)
- Remove streak gonads to reduce cancer risk
- Possible gestation with oocyte donation
Swyer syndrome involves 46 XY karyotype with functional female anatomy.
Amenorreia primaria + FSH level (>20) sem caracteres secundarios. Provavel etiologia.
Gonadal dysgenesis; requires karyotyping.
FSH is elevated in conditions like Turner syndrome or other forms of gonadal dysgenesis.
What is secondary amenorrhea defined as?
Absence of menstruation for 6 months or 3 consecutive menstrual cycles.
It is essential to rule out pregnancy during evaluation.
What is the most common cause of secondary amenorrhea?
Pregnancy.
Other causes may include stress, significant weight loss, and chronic illness.
What does a normal or reduced FSH level indicate in the context of secundary amenorrhea?
Hypothalamic dysfunction or possible pituitary disease.
This requires further investigation through imaging and hormonal tests.
IOP -critérios diagnósticos
- Irregular menstruation
- FSH > 25 (in two measurements >4 weeks)
POI can occur before age 40 and is often idiopathic.
What is the role of the GnRH test in amenorrhea diagnosis?
To differentiate between hypothalamic or pituitary causes of amenorrhea.
Lack of response indicates pituitary disease.
What is the treatment for premature ovarian insufficiency?
- Hormone replacement therapy (HRT)
- Contraception - 25% retoma a ciclar
HRT is recommended until the age of 50 unless contraindicated.
Causa mais comum de amenorreia primaria
Atraso puberal constitucional
