Amenorrhea/Reproductive Problems

Question 1

Hypogonadotrophic Hypogonadism

Answer 1

GnRH deficiency
Congenital: Kallman’s syndrome
Acquired: stress, exercise, malnutrition
Low FSH/LH & Estradiol

Question 2

Hypergonadotrophic Hypogonadism

Answer 2

Congenital: Turner’s
Acquired: Premature ovarian failure
High FSH/LH & LOW estradiol

Question 3

Premature Ovarian Failure

Answer 3

Ovarian failure before age 40
Hot flashes, irritability, dyspareunia
Vaginal and ovarian atrophy
Decreased bone density
Dyslipidemia
Usually autoimmune
FSH > LH

Question 4

Prolactinoma

Answer 4

Mass effect, galactorrhea, decreased libido
Low FSH/LH & estradiol
High PRL

Question 5

Hypothyroid

Answer 5

Fatigue, depression, cold intolerance, brittle nails, constipation, wt gain
High TRH reacts w/ FSH receptor = inhibit GnRH = low FSH/LH/estradiol

Question 6

PCOS

Answer 6

GnRH pulse that’s too high
Obesity, insulin resistance
Hirsuitism, acne (high androgens), acanthosis, nigracans
Ovulation rarely occurs = rare progesterone secretion b/c no corpus luteum = infertility
Risk of endometrial cancer, DM
Low LH/FSH (LH 2.5xFSH), High tonic estradiol
Increased DHEA-S/testosterone