Anovulation and Amenorrhea 4 Flashcards

Describe effective therapeutic approaches to the infertile couple.

1
Q

What is the treatment for anovulatory women with PCOS?

A
  • OCP or cyclic progestin to produce regular endometrial shedding
    • Will prevent irregular bleeding and minimize the risk of endometrial hyperplasia
    • If progestin is used, should be given for 12-14 days every month
  • Ideal therapy for anovulation in obese patients is weight loss
    • 5-10% will lead to regular menses or pregnancy in 80% of obese women iwth PCOS
  • Clomiphene citrate is another option
    • graduated regimen of 50-150 mg daily for 5 days
    • ovulation induced in 80% of women
    • fecundity of 0.22, similar to ferile women
  • Metformin and aromatase inhibitors or gonadotropins can be considered if other efforts to induce ovulation is not successful
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2
Q

What is the treatment for hypogonadotropic hypogonadism?

A
  • Psychological counseling
  • Modest wieght gain (1lb/week)
  • Reduction in exercise intensity
  • Estrogen replacement does not improve bone mineral content in women with eating disorders and amenorrhea
  • Daily injection of gonadotropins for about 10-14 days (LH and FSH activity) require to induce ovulation
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3
Q

What is the treatment for patients with POF?

A
  • Hormone replacement therapy to prevent osteoporosis
  • Want to reduce risk of CV disease
  • only effective fertility treatment is oocyte donation
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4
Q

What is the method of inducing ovulation and treating hypogonadism in women with hyperprolactinemia?

A

Cabergoline - dopamine agonist, 0.5 to 1 mg 2x/week

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