Ovulation Disorders

Question 1

Define oligomenorrheoea.

Answer 1

reduction in frequency of periods to less than 9/year

Question 2

Define primary amenorrhea.

Answer 2

failure of menarche to occur by age 16

Question 3

Define secondary amenorrhea.

Answer 3

cessation of periods for >6months in individual who has previously menstruated

Question 4

What should you consider in primary amenorrhea?

Answer 4

Consider congenital problems (Turner’s syndrome, Kallman’s syndrome)

Question 5

Describe some causes of secondary amenorrhea?

Answer 5

Ovarian problem: PCOS, Premature Ovarian Failure
Uterine problem: uterine adhesions
Hypothalamic Dysfunction: weight loss, over exercise, stress, infiltrative
Pituitary: high PRL, hypopituitarism

Question 6

Describe premature ovarian failure.

Answer 6

Amenorrhea, oestrogen deficiency and elevated gonadotrophins occuring < 40years of age, as a result of loss of ovarian function

Question 7

Describe causes of POF.

Answer 7

Chromosomal abnormalities (e.g. Turner’s syndrome, Fragile X)
Gene mutations (e.g. FSH receptor/LH receptor)
Autoimmune disease (e.g. association with Addison’s, thyroid, APS1/2)
Iatrogenic (radiotherapy/chemotherapy)

Question 8

What is secondary hypogonadism?

Answer 8

Hypogonadism as a result of hypothalamic or pituitary disease
Characterised by low oestradiol with low/normal LH/FSH

Question 9

What is hursitism and what causes it?

Answer 9

excess hair; usually used when referring to women with male pattern hair distribution
Caused by androgen excess at the hair follicle
Due to excess circulating androgen
Due to increased peripheral conversion at the hair follicle

Question 10

What is the most common cause of huristism?

Answer 10

PCOS

Question 11

What is congenital adrenal hyperplasia?

Answer 11

CAH is an inherited group of disorders characterised by a deficiency in one of the enzymes necessary for cortisol synthesis