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
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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
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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
      *
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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
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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
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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
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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
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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
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9
Q

What are some thyroid disorders that will cause amenorrhea?

A
  • Hypothyroidism
  • Hyperthyroidism
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