Ovulation Disorders Flashcards
Oligomenorrhea.
Reduction in frequency of periods to >9 a year (cycles >35 days)
Primary amenorrhea.
Failure of menarche by the age of 16 years
Secondary amenorrhea.
Cessation fo periods for >6 months in an individual who has previously menstruated
What are the physiolgical causes of amenorrhea?
Pregancy or post-menopausal
Give the causes of primary amenorrhea?
Congenital problems:
Turner’s syndrome
Kallman’s syndrome
What can cause seconary amenorrhea?
Ovarian problem
Uterine problem
Hypothalamic dysfunction
What should be looked at in someone who presents with amenorrhea?
Body shape - Turner's Visual fields Ansomia - Kallman's Breast development Hirsuitism - PCOS Acne - PCOS Galactorrhoea - hypopituitarism/ pituitary tumour
What symptoms are suggestive of oestrogen deficiency?
Flushing
Libido
Dyspareunia
What investigations do all that present with oligo/amenorrhea undergo?
LH FSH Oestradiol TFT's Prolactin
What additional investigations can be used to determine the cause of oligo/amenorrhea?
Ovarian US +/- endometrial thickness
Testosterone - if hirsuitism
Pituitary funtion tests and MRI pituitary - if hpituitary problem suspected
Karyotype - Turner’s syndrome
In terms of LH/FSH how does primary hypogonadism preset and what can cause it?
High LH/FSH - hypergonatrophic hypogonadism
Premature ovarian failure
In terms of LH/FSH how does secondary hypogonadism preset and what can cause it?
Low/ normal LH/FSH and low oestradiol
Problem with hypothalamus or pituitary
What are the signs of premature ovarian failure?
Secondary amenorrhea
Oestrogen deficiency
Elevated gonadotrophins occurring < 40 years of age
How is premature ovarian failure diagnosed?
FSH 430 on 2 separate occasions >1 month apart
What can cause premature ovarian failure?
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)
