Disorders of ovulation and the menstrual cycle Flashcards
Primary amenorrhea
No period by 15 y/o
Secondary amenorrhea
No periods for >3 months in a girl that previously had them
Oligomenorrhea
Fewer than 6 periods a year
Hirsutism
Excess androgen-dependent areas in women e.g. face, chest, abdomen, lower back
Virilization
Female develops characteristics associated with male hormones e.g. deep voice, reduced breast size, increased muscle bulk, male-pattern balding
Causes of secondary amenorrhea
- Ovaries - PCOS and premature failure
- Uterus - adhesions (PID)
- Hypothalamus/pituitary - hyperprolactinaemia, Cushing’s
- Other = hypothyroid, congenital adrenal hyperplasia, ovarian tumours
The Rotterdam criteria for PCOS
Must have 2/3:
- Oligo-/a- menorrhea
- Hyperandrogenism -> clinical fx or biochemical
Cystic ovaries - 20+ per ovary
Tests for PCOS
Test TSH and prolactin
Treatment for PCOS
Treats sx - weight loss/lifestyle
Infertility = clomifene and metformin
Function of 21-hydroxylase and 11B-hydroxylase
Catalyse aldosterone and cortisol
Function of 17B-hydroxylasw
Catalyse testosterone production
Non-classical congenital adrenal hyperplasia
Autosomal recessive disease causing oligomenorrhoea and fertility problems
Enzyme deficiency causes excess androgens and deficit of corticoids
Female athlete triad
- Oligomenorrhoea/amenhorrea
- Low energy
- Osteoporosis/paenia
Hypogonaotropic hypogonadism
Low pre-pubertal gonadotrophin, low oestrogen
Endocrine impacts of anorexia
Chronic starvation = reduced gnRH and LH = no periods
ADH inappropriately secreted = hyponatraemia and water retention
HPA elevated with high levels of CRH, ACTH and cortisol
