Amenorrhoea

Question 1

What are the causes of primary amenorrhoea?

Answer 1

• Turner’s syndrome
• Testicular feminisation
• Congenital adrenal hyperplasia
• Congenital malformations of the genital tract

Question 2

What are the causes of secondary amenorrhoea?

Answer 2

• Hypothalamic amenorrhoea (e.g. stress, excessive exercise)
• PCOS
• Hyperprolactinaemia
• Premature ovarian failure
• Thyrotoxicosis
• Sheehan’s syndrome
• Asherman’s syndrome

Question 3

Define Imperforate Hymen.

Answer 3

Congenital disorder where a hymen without an opening completely obstructs the vagina.

Question 4

What are the signs and symptoms of imperforate hymen?

Answer 4

• All other sexual characteristics developed
• Cyclical pelvic pain
• Amenorrhoea

Question 5

What are the appropriate investigations for suspected imperforate hymen?

Answer 5

USS → haematometra

Question 6

What are the appropriate investigations for suspected amenorrhoea?

Answer 6

• b-HCG → pregnancy
• Gonadotrophins → hypothalamic cause
• Prolactin → prolactinoma
• Androgens → PCOS, CAH
• Oestradiol → pregnancy
• Thyroid function → hypothyroid