Amenorrhea Flashcards
How does anorexia nervosa or significant weight loss cause hypothalamic-pituitary dysfunction?
a lack of normal pulsatile secretion of GnRH leads to decreased stimulation of the pituitary gland to produce FSH and LH which leads to anovulation and amenorrhea
What are the causes of hypothalamic-pituitary amenorrhea and what is first step to making diagnosis?
causes are functional(weight loss, obesity, excessive exercise), drugs(marijuana and tranquilizers), neoplasia, psychogenic(chronic anxiety and anorexia nervosa) and other chronic conditions; obtain FSH level and it will be low
What is most appropriate treatment for PCOS?
Oral OCPs
What is the most common cause of amenorrhea?
pregnancy
What are some symptoms of estrogen deficiency?
hot flashes and insertional dyspareunia
What is hypergonadotropic amenorrhea?
result of ovarian failure or follicular resistance to gonadotropin stimulation
What is absent in mullerian agenesis?
congenital absence of upper two thirds of vagina and of uterus and fallopian tubes
What is ashermans syndrome and what can it be caused by?
intrauterine synechiae or adhesions that result from trauma to basal layer of endometrium, which causes amenorrhea; can be caused by curettage, endometritis, pregnancy, etc
What cancer are women with PCOS at increased risk for?
endometrial hyperplasia and cancer due to chronic unopposed estrogen exposure
what is post pill amenorrhea?
history of irregular cycles prior to OCP use may increase risk of amenorrhea upon discontinuation
Why are women with hypothalamic amenorrhea(female athlete triad, nutritional deficiency) hypoestrogenic?
prolonged suppression of ovarian function; treat with combination of estrogen and progestin to cause enough proliferation of endometrial tissue for withdrawal bleed to occur
