Disorders of Reproductive Endocrinology Flashcards
Define primary amenorrhoea
Failure of menarche by the age of 16 years
Define secondary amenorrhoea
Cessation of periods for >6mths in an individual who has previously menstruated
What are the main causes for amenhorrhoea?
Physiological
- Pregnancy
- Postmenopausal
Primary amenhorrhoea
- Congenital (Turner’s, Kallman’s)
Secondary amenorrhoea
- Ovarian problems (PCOS, premature ovarian failure)
- Uterine problems (uterine adhesions)
- Hypothalmic dysfunction (weight loss, over exercise, stress, infiltrative)
- Pituitary problems (high PRL, hypopituitarism)
If a patient has amenorrhoea, what tests will they definitely undergo?
- LH, FSH and oestradiol
- Thyroid function, PRL
What is the difference between primary and secondary hypogonadism?
- Primary hypogonadism - low oestrogen due to ovary problem
- Secondary hypogonadism - low oestrogen due to hypothalmic or pituitary problem
Low oestradiol and low or inappropriately normal LH/FSH is indicative of what?
Secondary hypogonadism
Pituitary or hypothalmic problem
When oestradiol is low and LH/FSH are high then there is a __________ ovarian problem
When oestradiol is low and LH/FSH are high then there is a primary ovarian problem
What is idiopathic hypogonadotrophic hypogonadism?
Absent or delayed sexual development due to inability to activate GnRH secretion and associated with low levels of gonadotrophins and sex hormone levels in the absence of anatomical or functional defects
Kisspeptin has what important role in puberty?
GnRH release
What is Kallman’s syndrome?
A genetic disorder characterised by loss of GnRH secretion and either hyposmia or anosmia
Kallman’s syndrome affects which sex more?
Males
What is congenital adrenal hyperplasia?
A group of inherited disorders characterised by a deficiency in one of the enzymes necessary for cortisol synthesis
90% of CAH is due to a deficiency in which enzyme?
21α-hydroxylase
Classic CAH presents in ____________
Non-Classic CAH presents in ____________
Classic CAH presents in infancy
Non-Classic CAH presents in adolescence/adulthood
How does classic CAH present?
- Salt wasting
- Virilisation