Ovulation Disorders Flashcards
What us oligomenorrhea?
reduction in periods
Less than 9 per year
What is primary amenorrhea?
Failure to start periods by age 16
What is secondary amenorrhea?
Cessation of periods for >6 months
What are physiological causes of amenorrhea?
Pregnancy
Post-menopausal
Whats a classic history for amenorrhoea?
Oestrogen deficiency
weight loss/stress
etc.
Whats classical examination findings for amenorrhoea?
Body habitus/ turners
Visual fields/anosmia
breast development
Hirsutism/acne/androgen excess
What investigations should be done with suspected amenorrhoea?
LH, FSH, Oestradiol
Thyroid function, Prolactin
What other investigations may help with amenorrhoea?
Ovarian ultrasound +/- endometrial thickness
if hirsutism then testosterone
Pituitary function tests
Karyotype if primary with turner’s features
How is hypogonadism identified in females?
Low levels of oestrogen
What is primary hypogonadism?
Problem with ovaries
High LH/FSH - hypergonadotrophic hypogonadism
e.g. premature ovarian failure
What is secondary hypogonadism?
Problem with hypothalamus or pituitary
Low FH/FSH - hypogonadotrophic hypogonadism
e.g. high PRL, hypopituitarism
What is Premature Ovarian Failure (POF)
Amenorrhoea, oestrogen deficiency and elevated gonadotrophins occuring under 40 y/o as a result of loss of ovarian function
What investigation result should be checked for POF?
FSH 430 on 2 separate occasions
What are causes of POF?
Turners syndrome, fragile X
Gene mutations
AI disease e.g. Addisons, thyroid, APS1/2
Latrogenic (radio/chemotheraoy
What is secondary hypogonadism?
Result of hypothalamic or pituitary disease
Characterised by low oestradiol with low/normal LH/FSH
