Amenorrhoea

Question 1

Primary amenorrhoea?

Answer 1

No period by the age of 15 in the presence of normal secondary sexual characteristics or within 5 yr after breast development if this occurs before the age of 10 yrs

Question 2

Causes of hypothalamic amenorrhoea?

Answer 2

Nutritional insufficiency, excessive exercise, psychological stress, hyperprolactinaemia (macro/microadenoma), Sheehan’s

Question 3

Adrenal causes of amenorrhoea?

Answer 3

Cushing’s, adult onset CAH

Question 4

Ovarian causes of amenorrhoea?

Answer 4

PCOS, primary ovarian insufficiency(POI), ovarian tumours (rare)

Question 5

Uterine/cervical causes of amenorrhoea?

Answer 5

Absent uterus, cervical or vaginal agenesis, Ashermann’s

Question 6

Most common causes of amenorrhoea?

Answer 6

PCOS, POI, hyperprolactinaemia, hypothalamic amenorrhea

Question 7

Asherman’s syndrome?

Answer 7

Usually related to trauma of the endometrium, adhesions inside the uterine cavity and/or the endocervix

Question 8

Primary ovarian insufficiency (POI)

Answer 8

A loss of function of the ovaries before the age of 40 yrs.

Question 9

Investigations for POI?

Answer 9

Two FSH levels at least 1 month apart