Amenorrhea Flashcards
How do you define Primary Amenorrhea
no menses by 13 WITHOUT secondary sex ch, no menses by 15 WITH secondary sex ch
DDX of primary amenorrhea?
Constitutional, prolactinoma, PCOS, kallmans, stress, CAH, ovarian failure, genetic syndrome
Examples of hypergonad/hypogonadism
Turners, swyer syndrome, fragile X, idiopathic premature ov failure, chemo/rad
what labs do you order to eval primary amenorrhea?
HCG, Ovarian reserve (FSH/LH/E/AMH), TSH, Prolactinoma
routine evaluation of a turner syndrome patient?
cardiac echo/mri, renal sono, TFT, CBC, GLuc, lipid, celiac, hearing
phenotype of swyer syndrome
infantile female external genitalia, no breasts, streak gonads, +mullerian system
swyer syndrome why no testes?
NO DHT!! some have SRY
examples of hypothalamic amenorrhea?
physical/nutritional/emotional stress increases CRH, ACTH, cortisol, endorphins wHICH INHIBIT GnRH secretion
What is the female athlete triad
amenorrhea, disordered eating, osteopenia or osteoporosis
What is kallman syndrome
congenital GnRH deficiency (GnRH neuron migration problem)
examples of eugonadal hypogonadism
imperforate hymen, transverse vaginal septum, MRKH syndrome, androgen insensitivity syndrome
what is AIS?
absent androgen receptor! No testosterone response so NO wolffian ducts! There IS AMH, so no mullerian syndrome
phenotype of AIS
decreased axillary, blind ending vaginal pouch, large breasts, normal MALE serum testosterone, LH HIGH FSH NORMAL
fragile x premutation repeats?
55-199
