Amenorrhea

Question 1

primary amenorrhea definition: no menses by 14

Answer 1

in the absence of growth or secondary sex characteristics

Question 2

primary amenorrhea definition: no menses by 16

Answer 2

in the presence of normal growth and appearance of secondary sex characteristics

Question 3

secondary amenorrhea

Answer 3

no menses for 6 months in someone who already started mensturating

Question 4

maturation of ovarian follicle depends on

Answer 4

production of gonadotropins, FSH, and LH from ant pit

Question 5

what are the 4 compartments of defects for amenorrhea

Answer 5

1. outflow tract or uterus
2. ovary
3. ant. pit
4. hypothalamus

Question 6

what is asherman’s syndrome

Answer 6

adhesion of endometrium (ant/post wall)

-amenorrhea following endometrial destruction

Question 7

what is thought to be the cause of asherman’s syndomre

Answer 7

overzelous post-partum curettage

Question 8

how do you treat asherman’s syndrome

Answer 8

• lysis of adhesions (hysteroscope)
• post-op placement of foley (7days)
• post-op high dose cyclic E and P (2 months)
• -stimulate endometrial proliferation
• post-op antibiotics

Question 9

what are compartment 1 details

Answer 9

1. asherman’s syndrome
2. mullerian anomalies
3. vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome)
4. androgen insensitivy
5. cervical stenosis

Question 10

what are the 2 mullerian anomalies

Answer 10

1. imperforate hymen

2. Transverse vaginal septum

Question 11

transverse vaginal septum

Answer 11

• may be single or multiple
• result in s/s similiar to imperforate hymen
• -hematometra

Question 12

what is vaginal agenesis

Answer 12

congential absence of the vagina

-assocailed with cervical and uterine agenesis BUT there is a rudimentary uterine horn that is hormonally receptive

Question 13

vaginal agenesis is a primary or secondary amenorrhea

Answer 13

primary