amenorrhea Flashcards
what is the definition nof amenorrhea ?
absence of menses
define primary amenorrhea
non occurrence of menarche by the age of :
14 with no secondary sexual characteristics
16 with secondary sexual characteristics
define secondary amenorrhea
absence of menses for 3 consecutive cycles
what is the most common cause of false amenorrhea ?
imperforate hymen ( outflow obstruction)
what are the effects of imperforate hymen ?
accumulation of blood behind the hymen hematocolpos hematometra hematosalpinx pelvic haemorrhage
how can we diagnose imperforate hymen ?
Ultrasound
what is the treatment of imperforate hymen ?
cruciate incision under anesthesia
what are the common causes of true amenorrhea ?
physiologic delay of puberty
psychological trouble
rapid weight loss and exercise
what is kallman’s syndrome ?
congenital GnRh receptor deficiency
what is the typical presentation of kallman’s syndrome ?
loss of smell
amenorrhea
what kind of drugs can cause amenorrhea ?
antipsychotics TCA
Androgenic drugs Danazol
Combined OCPs , post pill amenorrhea
Progestins
what type of tumors and infiltrative lesions can cause amenorrhea ?
craniopharyngoma
lymphoma
what are the pituitary causes ?
hyperprolactinaemia:
prolactinoma
hypothyroidism
drug induced - dopamine receptor agonists
what are the pituitary insufficiency causes ?
sheehan’s synndrome
simmond’s syndrome
pituitary infarction
sheehan eventually causes simmonds
what is a congenital pituitary related cause of secondary amenorrhea ?
empty sella syndrome
what are the ovarian causes of amenorrhea ?
PCOS Premature ovarian failure Turner Syndrome ( 45 XO )
what is the most common cause of primary amenorrhea ?
turner syndrome
what is different about mosaic turner ?
some cells are 45 XO whilst other are 46 XX
what are the uterine causes of amenorrhea ?
Androgen insensitivity syndrome
Asherman’s Syndrome
complete or partial mullerian tract agenesis
what are the features of individuals that have partial or complete mullerian agenesis ?
46 XX
normal ovaries so she has secondary sexual characteristics
primary amenorrhea and infertility
( externally she looks normal )
how can we diagnose a case of complete or partial mullerian agenesis ?
ultrasound
HSG
MRI
karyotyping
what are the features of an individual with androgen insensitivity syndrome ?
46 XY
androgen receptors only responsive to E2
external genitalia is female
no pubic hair or axillary hair
what operation can be performed for individuals that have androgen insensitivity syndrome ?
Mcindoe operation ( operation to form a vagina to allow for intercourse )
what is the main complaint of a patient with Sheehan syndrome ?
complains of no breastfeeding and hypothyroidism
