Amenorrhea Flashcards
Primary amenorrhea definition
No menses by the age of 16 and 14 if with normal and no normal secondary sexual characteristics respectively.
No menstruation after 5 years of telarche
No telarche by the age of 13
Secondary amenorrhea definition
Absence of menses for 6 months
Premature ovarian failure definition
Loss of ovarian function before 40
Elevated FSH and low estradiol
FSH >/= 25-40 IU 4 weeks apart
Metabolic syndrome
central obesity
lipid abnormalities
hypertension
elevated glucose levels
Metabolic syndrome specific values for central obesity
Male >90
Female >80
Metabolic syndrome specific values for lipid abnormalities
HDL <1 in men <1.3 in women
Triglycerides >/= 1.7
Metabolic syndrome specific values for hypertension
130/85
Metabolic syndrome specific values for elevated glucose
> 5.5
Criteria for PCOS
hyperandrogensim
anovulatory cycles
polycystic ovarian morphology
PCOS Pathophysiology
Hypothalamus –> GNRH
Pituitary –> FHS LH
Ovary and adrenals –> androgen
Hypothalamus rapid pulses leading to LH>FSH
LH increase leads to increase in progesterone –> androgen
Ferriman Gallwey scoring
9 items
0-4 per category
>/= 6 diagnostic of hirsutism
Polycystic ovarian morphology
> /=12 follicles with (2-9mm in diameter)
Inceased in the volume of the ovary of > 10mL
Decreased findings in PCOS
SHBG and FASH
Rotterdam Phenotype for PCOS A
Hyperandrogenism
Menstrual irregularity
PCOM
Hyperandrogenism +
Menstrual irregularity +
PCOM +
Increased findings in PCOS
LH
LH:FSH >3
Testosterone, andostrendione, DHEA, DHEA-S
Estrone
AMH >4.7
Prolactin (20-35)