Gynaecology - Ameorrhoea Flashcards
1
Q
Amenorrhoea?
What is it?
A
Defined as primary or secondary amenorrhoea:
- Primary - menstruation has not occurred by the age of 16
- Secondary - absence of menstruation for 6 months in a woman who previously had normal menstruation
2
Q
Amenorrhoea?
Causes - Primary?
A
Primary causes: 2T 2C
- T - Turner Syndrome(45X - missing x chromosome)
- T - Testicular feminisation
- C - Congenital malformations (Mayer-Rokitansky-Kuster-Hauser syndrome - underdeveloped vagina/uterus)
- C - Congenital adrenal hyperplasia
3
Q
Amenorrhoea?
Causes - Secondary?
A
Secondary Causes: (4P 3H)
- P - Pregnancy (most common cause)
- P - Polycystic ovary syndrome
- P - Premature ovarian failure
- P - Pituitary hormone necrosis
- H - Hyperprolactinaemia
- H - Hypothalamic disorder (anorexia, xs exercise, stress)
- H - Hyper/Hypothyroidism
4
Q
Amenorrhoea?
Symptoms?
A
Some examples:
- PCOS
- Turners Syndrome
- Premature ovarian failure (Addison/hypothyroidism)
- Mayer-Rokitansky-Kuster-Hauser: uterovaginal aplasia/dysplasia
5
Q
Amenorrhoea?
Investigations?
A
- B-hCG levels to exclude pregnancy
- Blood tests: FBC, U&Es. TFTs, gonadotrophin levels, prolactin, androgen, oestradiol
- Radiology
6
Q
Amenorrhoea?
Treatment?
A
Dependant on causes of amenorrhoea:
Conservative - patient education
Medical - PCOS see later
- Premature ovarian failure - hormone replacement therapy
Surgical - depends on underlying pathology
- Surgical procedures
7
Q
Amenorrhoea?
Complications?
A
- Infertility
- Osteoporosis
