Ovulation disorders Flashcards
Surge in what triggers ovulation
LH
When does oestradiol peak?
Before ovulation
When does progesterone peak?
after ovulation
What is the progesterone challenge test?
Menstrual bleed in response to a five day course of progesterone: indicates oestrogen levels normal
Hypothalamic pituitary failure: gonadotropin levels and progesterone challenge test results?
Hypogonadotrophic hypogonadism Low levels gonadotrophins Oestrogen deficiency Negative progesterone challenge test Normal prolactin
Gonadotropin injections are associated with what
Higher multiple pregnancy rates
Management of hypothalamic anovulation
Stabilise weight
Pulsatile GnRH if hypog hypog
Gonadotropin daily injections
Gonadotropin and oestrogen levels in hypothalamic pituitary dysfunction?
Normal gonadotropins
Normal oestrogen levels
Insulin and PCOS
Body doesn’t respond as well to insulin - glucose intolerance
Body just makes more insulin = hyperinsulinemia
Insulin lowers SHBG levels - hyperandrogenism
Treatment to induce ovulationin PCOS?
1) Clomifene citrate
2) Gonadotropin therapy
3) Laproscopic ovarian diathermy
Why would you give metformin in PCOS?
Improves insulin resistance
Restoration of menstruation and ovulation
May increase pregnancy rates
May not experience puberty/puberty may be incomplete and have symptoms associated with hypogonadism:
Men: decreased libido, erectile dysfunction, decreased muscle strength, diminished aggressiveness and strength
Women: amenorrhea, dyspareunia (because of decreased vaginal lubrication
Kallmann syndrome
Oligomenorrhea
Cycle more than 35 days
Less than 9 periods a year
Oligomenorrhea
Cycle more than 35 days
Less than 9 periods a year
1/1 - 1/10
Very common
