Amenorrhoea Flashcards
Primary vs secondary amenorrhoea
Primary is no period by 14 without sexual characteristics or no period by 16 with sexual characteristics, secondary amenorrhoea is previously normal and now no period for 6 months
What potential areas of the body can cause amenorrhoea and therefore question areas you need to highlight in the history?
Menstrual history, outflow tract, pituitary, hypothalamus
2 of what 3 features of PCOS must be present for diagnosis?
12 peripheral follicles over 10cm2 volume, oligo-anovulation (less than 8 periods a year), clinical and biochemical signs of hyperandrogenism
Less common causes of PCOS?
Cushings disease, adrenal hyperplasia, thyroid dysfunction, hyperprolactinaemia, androgen secretin tumour
If a patient is clinically hyperandrogenism and total testosterone level is over 5nmol/L what needs to happen?
test for CAH with 17-hydroxyprogesterone
Long term health risks due to PCOS?
T2DM, CV risk with hypertension, sleep apnoea due to BMI, endometrial cancer, depression
2 drugs that can induce weight reduction? 1 insulin sensitising agent that is used?
Orlistat and sibutramine. Metformin
best OCP to be on with PCOS
Dianette
What cream can be used to get rid of facial hirtuism?
Eflornithine
What type of drug is Clomifene and what does it help?
Clomifene is an oestrogen receptor antagonist which causes a lack of negative feedback to the hypothalamus and therefore increased levels of FSH and LH and ultimately helps with fertility
What does IUI and ICSI stand for?
intrauterine insemination, intracytoplasmic sperm injection
How do you check for tubal patency?
Hysterosalpingogram
In PCOS sufferers, when do you check their levels of FSH, LH, Oestradiol and progesterone
Day 2 of cycle check FSH, LH, oestridiol and then half way through luteal phase check progesterone
What 2 risks increase in pregnancy due to PCOS? test for one?
Gestational diabetes (OGTT) and increased risk of miscarriage
