Amenorrhoea Flashcards
1
Q
What is primary and secondary amenorrhoea?
A
Primary - failure to have menarche
secondary - stops having periods for >6/12
2
Q
What causes primary amenorrhoea WITHOUT secondary sex characteristics?
A
- Turners syndrome
- androgen insensitivity syndrome
- congenital adrenal hyperplasia
3
Q
What causes primary amenorrhoea WITH secondary sex characteristics?
A
Genitourinary malformation - imperforate hymen
4
Q
What causes secondary amenorrhoea?
A
- disruption of normal HPA functioning - stress, eating disorders, excess sport
- hyperprolactinaemia - ectopic/pituitary tumour production
- ovarian causes - PCOS or menopause
- asherman’s
- uterine adhesions
5
Q
Investigations and rationale for them for amenorrhoea?
A
- Urine pregnancy test - they can stop periods
- free androgen - raised in PCOS
- FSH and LH - supressed in HPA disruption
- prolactin - pituartary tumour
- TFTs - hyper/hypothyroid causes irregular periods
- Testosterone - secreting tumour of CAH
6
Q
How do you treat amenorrhoea?
A
- dependent on cause
- early menopause - HRT
- pituitary tumour transphenoidal removal
- CAH - Fludrocortisone and hydrocortisone