Amenorrhea Flashcards
Primary Amenorrhea Definition: the absence of menarche at __ years of age despite normal development of____
15
secondary sexual characteristics
Primary Amenorrhea Definition: Also: absence of menses at __years of age in female individuals with ________
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no secondary sexual characteristics
Causes of primary amenorrhea include
Gonadal dysgenesis (Turner syndrome) Müllerian agenesis Delay of puberty Polycystic ovary syndrome (PCOS) Hypopituitarism
Also remember that _____amenorrhea can
present as ___amenorrhea,
secondary
primary
Initial testing for primary amenorrhea includes:
β-HCG TSH Prolactin FSH Pelvic ultrasound (to assess for presence of a uterus)
Primary Amenorrhea tx
depends on the cause of the amenorrhea
Secondary Amenorrhea is the absence of menses for more than __ months in a
female who menstruates regularly or absence of menses for _ months in a female who menstruates irregularly.
3
6
Causes of secondary amenorrhea include:
Pregnancy (the most common cause of secondary amenorrhea) Hypothalamic amenorrhea Hyperprolactinemia Primary ovarian insufficiency Polycystic ovarian syndrome Thyroid abnormalities
Best initial test for secondary amenorrhea is
β-HCG—this is done first.
what to do if β-HCG is negative
TSH.
what to do if high free t4
treat hypothyroidism with Levothryroxine
what to do if low free t4
treat hyperthyroidism with propylthiouracil (PTU) or methimazole
what to do if TSH is normal
ask Prolactin
what to do if high prolactin
primary ovarian insufficency: check for symptoms: hot flashes, vaginal dryness
what to do if normal prolactin
ask estradiol
