Anovulation and Amenorrhea 1 Flashcards
List the common causes of secondary amenorrhea.
1
Q
What is the definition of primary vs. secondary amenorrhea vs. anovulation?
A
-
Primary amenorrhea
- no menses by age 16
- no breast development by age 14
-
Secondary amenorrhea
- no menses for 6 months
-
Anovulation
- amenorrhea
- oligomenorrhea
- dysfunctional uterine bleeding
2
Q
What are the common presentations of anovulation?
A
-
Amenorrhea
- menses at > six month intervals
-
Oligomenorrhea
- menses at > 35 days to six month intervals
-
Abnormal uterine bleeding
- irregular, unpredictable, and sometimes heavy vaginal bleeding
3
Q
What are some common causes of secondary amenorrhea?
A
- Pregnancy - most common
- Regular breast feeding
- Contraception
- oral contraceptive pill
- progestin-only pill
- progestin injections
- implants or IUDs
- due to endometrial atrophy
*
4
Q
What are some common causes of hypothalamic-induced amenorrhea?
A
- Weight loss
- Stress
- Exercise
- Tumor
- Infiltrative disease
- Congenital hypogonadotropic hypogonadism (Kallmann’s syndrome for example)
- Constitutional delay of puberty
5
Q
What are some common causes of pituitary-induced amenorrhea?
A
- Hyperprolactinemia
- non-prolactin secreting tumor
- Sheehan’s syndrome
- GnRH receptor gene mutation
- LH-beta mutation
- FSH-beta mutation
6
Q
What are some common causes of ovary-induced amenorrhea?
A
- Premature ovarian failure with normal chromosomes
- Premature ovarian failure with abnormal chromosomes
- PCOS
- Androgen secreting tumors
- Galactosemia
- LH receptor mutation
- FSH receptor mutation
- Congenital adrenal lipoid hyperplasia
- 3-beta-hydroxysteroid dehydrogenase deficiency
- 17-hydroxylase/17,20-lyase deficiency
- Aromatase deficiency
7
Q
What are some common causes of uterus/outflow tract-induced amenorrhea?
A
- Asherman’s syndrome
- Androgen receptor mutation (androgen insensitvity syndrome)
- Uterine and vaginal aplasia (Rokitansky-Kuster-Hauser syndrome)
- Transverse vaginal septum
- Imperforate hymen
8
Q
What adrenal disroders will cause amenorrhea?
A
- Congential adrenal lipoid hyperplasia
- 21-hydroxylase deficiency
- 11-hydroxylase deficiency
- 3-beta-hydroxysteroid dehydrogenase deficiency
- Cushing’s syndrome
- 17-hydroxylase/17,20-lyase deficiency
9
Q
What are some thyroid disorders that will cause amenorrhea?
A
- Hypothyroidism
- Hyperthyroidism