Hormonal Causes of Infertility Flashcards

1
Q

define oligomenorrhea

A

less than 9 periods per yr

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2
Q

describe difference between primary and secondary amenorrhea

A

primary - failure of menarche by 16 yearhs

secondary- cessation of periods for more than 6 months in person who has previously menstruated

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3
Q

physiological causes of amenorrhea

A

pregnancy

postmenopausal

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4
Q

causes of primary amenorrhea

A

turners

kallmans

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5
Q

causes of secondary amenorrhea

A
PCOS
POF
uterine adhesions
weightloss, over exercise, stress
high prolactin, hypopituitrism
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6
Q

define primary hypogonadism and give example

A

problem with the ovaries such as POF

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7
Q

define secondary hypogonadism

A

problem with hypothalamus/pituitary eg high prolactin, hypopituitarism

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8
Q

define premature ovarian failure

A

amenorrhea, oestrogen deficiency and elevated gonadotrophins occurring at less than 40 years of age, as a result of loss of ovarian function

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9
Q

what measurements must be taken to diagnose POF

A

FSH more than 30 on 2 separate occasions more than 1 month apart

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10
Q

give causes of POF

A

turners, fragile x
gene mutations (FSH/LH receptors)
autoimmune disease eg addisons
iatrogenic (chemotherapy)

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11
Q

give causes of secondary hypogonadism

A
kallmans
IHH
pituitary problem
prader willi
haemochromatosis
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12
Q

what can cause functional hypothalamic amenorrhea

A
weight change
stress
exercise
anabolic steroids
systemic illness
surgery
recreational drugs
head trauma
sarcoidosis
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13
Q

key features of kallmans

A

loss of GNRH secreation +/- anosmia
50-75 percent have anosmia
normal pituitary function

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14
Q

what gender is kallmans more common in

A

men

4:1

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15
Q

what percentage of IHH cases are kallmans

A

60 percent

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16
Q

what proportion of kallmans is inheritied

17
Q

what mutations results in x linked inheritance of kallmans

A

KAL 1 gene

18
Q

give causes of pituitary dysfunction

A
piturary macroadenoma
empty sella
pituitary infarct
hyperprolactinaemia
micro/macro-prolactinoma
drugs (dopamine antagonists)
19
Q

give the diagnostic criteria for PCOS

A

2 of three of:
menstrual irregularity
hyperandrogenism
polycystic ovaries

20
Q

what is turners syndrome

21
Q

clinical features of turners syndrome

A
short stature
webbed nicek
shield chest with wide spaced nipples
cubitus algus
no menstruation 
rudimentary ovaries
22
Q

what other conditions are associated with turners

A
cardiovascular problems - coartication of aorta
gi problems
lymphaedema
hypthyroidisms
osteoporosis
scoliosis
otitis media
renal anomalies
23
Q

what is hirsuitism

A

excess hairs im a male pattern

24
Q

what causes hirsuitism

A

androgen excess at the hair follicle

  • due to excess circulating androgen
  • due to increased peripheral conversion at the hair follicle
25
what is congenital adrenal hyperplasia
inherited group of disorders characterised by deficiency in one of the enzymes required for cortisol synthesis usually 21 alpha hydroxylase
26
how Is cah inherited
autosomal recessive If classic - will present in childhood if non classic and only partial deficiency may present in adulthood
27
list causes of hyperandrogenism
``` PCOS CAH cushings acromegaly androgen secreting tumour ```
28
causes of male primary hypogonadism
``` klinefelters cryptochidims testicular trauma torsion orchiditis chemotherapy varicocoele ```
29
causes of secondary hypogonadism in males
same as female-kallmans, prader willi | hyperprolactinaemia
30
causes of gynaecomastia
``` physiological drugs eg spironolactone hypogonadism tumours endocrine- cushings systemic illness hereditary disorders ```