Amenorrhea and Menopause Flashcards
3 Main causes of primary amenorrhea?
- Gonadal probs
- Mullerian probs
- Androgen insenstiivity
What happens to Swyer’s Syndrome’s Gonads?
SNIP SNIP
What is the genotype and genital presentation of a Swyer’s Syndrome patient?
- 46 XY
- Uterus
Name the 2 main types of anomalies MRKH (Vaginal Agenesis) patients have
- Renal
- Skeletal
____-____-____-____ (____ _____) has breasts present, but uterus absent due to Mullerian duct lack of development
- Mayer-Rokitanksy-Kuster-Hauser (Vaginal Agenesis)
AKA MRKH
____ Syndrome is the #1 Post-Partum problem resulting in failure to lactate
Sheehan’s
(hormone loss from necrosis/blood loss)
-Mayer-Rokitanksy-Kuster-Hauser (MRKH) patients have what genotype and present with what kind of genitalia?
- 46XX
- No uterus
Menopause is the cessation of menses for one year with FSH levels usually greater than ____, however a diagnosis can be made with just clinical information
25 IU/L
3 Types of congenital Vaginal Outflow tract obstructions
- Absence
- Imperforate Hymen
- Transverse Vaginal Septum
If a patient has breasts absent and uterus absent, then the most likely deficiency is ________ase
17-OH
3 differences of Imperforate Hymen vs Transverse Vaginal Septum
- Imperforate has a Bulge and easily treated
- Transverse has a complex treatment
- Transverse doesn’t have cervix present
_____ syndrome results in gonadal dysgenesis with a mutation in the ____ gene. A uterus will be present.
- Swyer’s
- SRY
“Sorry swyer”
How does PCOS respond to the progestin challenge?
Expected vaginal bleeding
Utero-Vaginal obstruction, Ovarian Failure, and Hypothal Dsfxn are 3 causes of secondary amenorrhea that have what in common?
Fail the Progestin challenge
Even though neither have a Uterus developed, what’s the Key differences between MRKH and 17-OHase deficiency (name one for each disorder)?
- MRKH HAS BREASTS
- 17 OHase deficiency has HTN
After a progestin challenge you expect bleeding, if there’s appropriate bleeding then you would suspect ____ ____ causing SECONDARY amenorrhea
Anovulation PCOS
_____ Syndrome, Cervical Stenosis, and Pelvic radiation are the main causes of Acquired Uterovaginal Obstruction
Asherman’s
“Sticky Asherman”
When assessing for secondary amenorrhea, if they fail the Progestin challenge, what are the next two steps?
- Estrogen First
- Estrogen and Progesterone Second
3 Main SECONDARY amenorrhea disorders that fail the progestin bleed challenge?
- Utero-Vaginal Obstruction
- Ovarian Failure
- Hypothal Dysfxn
Aside from the karyotype, what’s a key difference between Mullerian Agenesis (MRKH) and Androgen insensitivity?
MRKH has many renal and skeletal anomalies
