Amenorrhoea Flashcards
Primary amenorrhoea is defined as not starting menstruation by
13 years when there is no other evidence of puberty
15 years when there are other signs of puberty
Normal Puberty starts age … in girls
8-14
Normal Puberty starts age … in boys
9-15
Hypogonadotropic hypogonadism is caused by
deficiency in LH and FSH
Hypergonadotropic hypogonadism is caused by
a lack of response to LH and FSH
causes of Hypogonadotropic Hypogonadism
Hypopituitarism
Damage to the hypothalamus or pituitary
Chronic conditions (cystic fibrosis or IBD)
Excessive exercise
Constitutional delay
Endocrine disorders
Kallman syndrome
endocrine causes of Hypogonadotropic Hypogonadism
growth hormone deficiency
hypothyroidism
Cushing’s
hyperprolactinaemia
in Hypergonadotropic Hypogonadism levels of LH and FSH are
raised
Causes of Hypergonadotropic hypogonadism
damage
congenital absence of ovaries
Turner’s syndrome
hypogonadotrophic hypogonadism and absent sense of smell
Kallman syndrome
Congenital Adrenal Hyperplasia is inherited in what pattern
autosomal recessive
Features of Congenital Adrenal Hyperplasia
girls
tall
facial hair
amenorrhoea
deep voice
early puberty
Androgen Insensitivity Syndrome results in
female phenotype but absent ovaries / uterus
All girls with primary amenorrhoea should be tested for what co-morbidities / causal diseases
CKD, coeliac, Thyroid dysfunction
In patients with hypogonadotrophic hypogonadism what can be given to induce ovulation and menstruation
pulsatile GnRH
COCP
Define secondary amenorrhoea
no menstruation for more than three months after previous regular menstrual periods
most common cause of secondary amenorrhoea
pregnancy
Pituitary causes of secondary amenorrhoea
tumours
pituitary failure
causes of pituitary failure
trauma
radiotherapy
Sheehan syndrome
Treatment of hyperprolactinaemia
dopamine agonists (bromocriptine, cabergoline)
High LH, or LH:FSH ratio in context of secondary amenorrhoea is suggestive of
PCOS
Raise testosterone in context of secondary amenorrhoea is suggestive of
PCOS
androgen insensitivity
congenital adrenal hyperplasia
