Ammenorrhea Flashcards
Primary amenorrhea
No prior menstruation
At 13 to 16 years of age with no secondary sexual characteristics
Which axis is responsible for menstruation
Hypothalamo(gnrh)
pituitary(FSHandLH)
ovarian axis
Then high estrogen level decreases gnrh level
Most common cause of primary amenorrhea is?
Turner syndrome
Characteristics of turner syndrome includes?
Absent 2 sexual characteristics
Short statue
Webbed neck or wide neck
45x or absent X chromosome
No estrogen and progesterone thus increased FSH and LH
Ovaries replace dvt gonades
Second most common cause of primary amenorrhea is?
Mullerian agenesis
Mullerian agenesis characteristics includes?
Obstructed uterus cervix and 2/3 of vagina
Painful sex( dysparenunia)
Infertility
Normal fsh and lh level since they have a normal ovary
3 rd cause of primary ovarian syndrome include?
Androgen insensitivity syndrome
Which is androgen receptors do not respond for testosterone
Androgen insensitivity syndrome characterized by?
Normal testicles so normal FSH and LH level high estrogen which have female characteristics externally
Sparse body hair
No pubertal acne
4th cause of primary amenorrhea is?
Kallman syndrome
Kallman syndrome includes
Failure of GNRH migration from nose to hypothalami
Low GNRH FSH LH ESTROGEN
Absence sensitivity to smell
Secondary ammenorrhea
No menses for 3 cycles for normal menstruating
Or
Absence for at Least 6 month on irregularly menstruating
Functional hypothalamic ammenorrhea cause
Stress
Malnutrition
Stress
Weight loss
Exercise
Polycystic ovarian syndrome
Cause of secondary ammenorrhea
Low progesterone and high LH
High testosterone and hirsutism
Other causes of secondary ammenorrhea are?
Prolactinoma
Hypothyroidism
Premature ovarian failur ma Sherman syndrome
Character of premature ovarian failure is?
Vaginal dryness
Hot flashes
Ashermann syndrome is
Intra uterine adhesion
Causes infertility
Diagnosis of ammenorrhea is made by serum FSH LH Prolactin TSH Estrogen testosterone level
Testosterone
Karyotype is done for
Turner syndrome
Androgen insensitivity syndrome
Other IX for ammenorrhea includes
U/s
Hysteroscopy
COC is used to treat which ammenorrhea
PCOS and premature ovarian failure
Dopamine agonist (cabaroline )is used ?
To shrink pituitary adenoma
