Amenorrhoea Flashcards
What is primary amennorhoea?
In these patients, menstruation has never occured spontaneously.
- (14 y/o)
- No secondary sex characteristics
- Never had a period - (16 y/o)
- Have secondary sex characteristics
- Never had a period
What causes primary amenorrhoea?
- Chromosomal Abnormalities
- Turner Syndrome (results from a missing or incomplete sex chromosome)
- Congenital anomaly of the uterus
- Uterus septum
- Uterus didelphys (two uterus with two cervices)
- Septum in the vagina
Management of primary amenorrhoea?
-Refer
What is secondary amenorrhoea?
- Absence of menstruation when menses have previously occured, even if the patient has only had one spontaneous menstrual bleed.
- has has period before, but now been absent for 3-6 months.
When is amenorrhoea normal? (physiological)
- Pregnancy
- Post Menopause
- Lactation
What are the causes of secondary amenorrhoea?
diagramm
- Hypothalamus causes
- Extreme stress
- Anorexia
- Athletes doing extensive training. - Anterior Pituitary- really rare
- Prolactinoma (causes pituitary to make increases prolactin, puts the body in lactational stage)
*Signs of prolactinoma
-Headaches and vomiting (increased ICP)
-Visual defect
Bitemporal hemianopia
-Galactorrhoea
-Tumour (unrelated tumour)
Tumour compressing the pituitary, no hormones released, causes amenorrhoea
- Signs of Tumour
- Headaches and vomiting
-Sheehan’s Syndrome
Severe haemorrhage causes pituitary to infarct
- Signs
- Hx of profound PPH
- Thyroid causes
- usually HYPERthyroidism
- Signs of Hyperthyroidism
- LOW
- Heat intolerance
- Sweating and irritability
- Palpitations
- Fatigue
- Abnormal protrusion of eyes/puffy eyes
4.Adrenal Glands Causes
*Cushings Syndrome
(over-production of cortisol)
*Addison’s Disease (adrenal gland does not produce enough cortisol and sometimes aldosterone)
- Ovary causes
- PCOS
* Most common cause of oligo- and amenorrhoea
-Premature Ovarian Failure (rare)
*Very early
menopause, earlier than 45 year
Other Sx of POF -Flushes, mood swings, insomnia and dyspareunia
- Uterus
-Asherman’s Syndome
Damage to the basal cellular layer of the endometrium after a procedure (Metal currette during miscarriage evac)
-Stenosis of cervix
Due to LLETZ or cone biopsy
