Amenorrhea

Question 1

Gonadarche

Answer 1

Activation of gonads by the pituitary hormones (FSH, LH)

Question 2

Adrenarche

Answer 2

Increase in production of androgens by adrenal cortex

Question 3

Thelarche

Answer 3

Appearance of breast tissue

Question 4

Spermarche

Answer 4

Time of first sperm production

Question 5

Pubarche

Answer 5

Appearance of pubic hair

Question 6

Menarche

Answer 6

• Time of first menstrual bleed
• often anovulatory (no ovulation)
• caused solely by effects of estradiol on endometrial lining

Question 7

NML menstruation requirements

Answer 7

• Karyotype 46, XX
• Intact hypothalamic fxn (GnRH)
• Intact pituitary fxn (FSH, LH, PRL)
• Intact ovarian fxn (estrogens and progesterone)
• Intact uterus with endometrial fxn
• patent cervix and vagina

Question 8

Amenorrhea

Answer 8

Absence of menses

Question 9

Primary amenorrhea

Answer 9

Absence of menarche by age 15 in presence of NML growth and secondary characteristics OR
no menses by age 13 PLUS absence of onset of pubertal development such as absent breast development OR 16 regardless of presence of secondary sex characteristics

Question 10

Secondary amenorrhea

Answer 10

Absence of menses for more than 3 cycles or for 6 months in women who were previously menstruating

Question 11

Gonadal dysgenesis

Answer 11

• MCC of primary amenorrhea
• caused by chromosomal abnormalities
• results in premature depletion of all ovarian oocytes and follicles
• EX.) Turner, Mosaic Turner (some 45, XO some NML 46, XX)