Ammenorhoea Flashcards
What is the mechanism of action of the COCP?
Increase levels of oestrogen and progesterone, causing negative feedback on anterior pituitary and thickening the endometrium
What is the most common type of amenorrhoea?
Secondary
What is the definition of primary amenorrhoea?
Not starting menstruation when:
- 13 years old where there is no other evidence of pubertal development
- 15 years old when there are other signs of puberty
What subcategories can sex hormone deficiency be divided into?
Hypergonadotropic Hypogonadism
Hypogonadotropic Hypogonadism
Explain Hypergonadotropic Hypogonadism
A lack of response from the gonads results in a lack of production of oestrogen. Consequently, there is no negative feedback on the anterior pituitary resulting in the excess production of FSH and LH
What is Hypergonadotropic Hypogonadism?
High FSH/LH low Sex Hormones
What is Hypogonadotropic Hypogonadism?
Low FSH/LH low sex hormones
Explain Hypogonadotropic Hypogonadism
Low FSH/LH production reduces prevents the release of oestrogen
What syndrome is associated with Hypogonadotropic Hypogonadism?
Kallman syndrome
What are the causes of Hypogonadotropic Hypogonadism?
- Hypopituitarism
- Damage to Pituitary/Hypothalamus
- Excessive exercise/dieting
- Constitutional delay in growth and development
What is a characteristic feature of Kallman’s?
Change to sense of smell and delayed puberty/development
What is congenital adrenal hyperplasia?
Deficiency of 21-hydroxylase enzyme causing underproduction of sex hormones
What is the definition of secondary amenorrhoea?
No period for more than 6 months when a woman previously has had periods
What is the most common cause of secondary amenorrhoea?
Pregnancy
What are the causes of secondary amenorrhoea?
- Pregnancy
- Menopause
- Hormonal contraception
- Polycystic Ovarian Syndrome
Which syndrome is associated with secondary amenorrhoea?
Ashermann’s - complications post-uterine surgery
What are the investigations for amenorrhoea?
- HcG
- Estrogen/Progesterone
- FSH/LH
- Prolactin
- Testosterone
How is primary hypogonadotropic amenorrhoea treated?
COCP
How is primary hypergonadotropic amenorrhoea treated?
GnRH analogues
How is secondary amenorrhoea treated?
Underlying cause
