Disorders that affect periods

Question 1

State the most common cause of infertility in young women

Answer 1

PCOS

Question 2

Symptoms of PCOS

Answer 2

Hair growth, premature follicles that look like cysts on ovaries, few/irregular periods, acne

Question 3

Diagnosis of PCOS

Answer 3

Hyperandrogenism
Cystic ovaries
Oligo-anovulation

Question 4

Pathogeneis of PCOS

Answer 4

1. More androgens (hyperandrogegism) causes raised testosterone and therefore dihydrotestosterone levels
2. This causes impaired follicular genesis so a lot of follicles are stimulated but don’t reach maturation (gives them polycystic morphology)
3. Because the eggs don’t fully mature there is anovulation. This is because FSH levels are low and no surge in LH
4. Lots of maturing eggs increases oestrogen levels which signal hypothalamus to increase GnRH so FSH goes down further and LH goes up

Question 5

Why are women with PCOS at higher risk of developing Type 2 diabetes?

Answer 5

Because lots of maturing follicles increases levels of oestrogen which increases circulating insulin

Question 6

How does low BMI cause amenorrhoea?

Answer 6

Loss of GnRH secretion due to stress

Question 7

Why does high BMI affect periods?

Answer 7

Causes increase in oestrogen which alters feedback

Question 8

What does testing for prolactin in blood check for?

Answer 8

An anterior pituitary tumour because if it is in range GnRH function is OK so anterior pituitary is fine.

Question 9

What are fibroids?

Answer 9

Abnormal growths. Typically benign but cause abdominal pain and heavy periods