Ovulatory Disorders Flashcards
How long is the normal menstrual cycle?
28-35 days
If someone has oligomenorrhoea, how long do menstrual cycles last?
Greater than 35 days
What is the difference between primary and secondary amenorrhoea?
Primary: never had a period before 16yrs old
Secondary: not had a period for 6mths in a person who has had a period before
What is another name for an ovulatory disorder caused by hypothalamic pituitary failure?
Hypogonadotrophic hypogonadism
Which syndrome is associated with hypogonadotrophic hypogonadism?
Kallman’s syndrome
Outline management of hypogonadotrophic hypogonadism
Pulsatile GnRH Gonadotrophin injections Stabilise weight (BMI over 18.5)
What is the most common ovulatory disease caused by hypothalamic pituitary dysfunction?
Polycystic ovarian syndrome
What is the criteria for diagnosing polycystic ovarian syndrome?
Oligo/amen -orrhoea
Polycystic ovaries on USS (12+ 2-9mm follicles)
Hyperandrogenism
Insulin resistance is commonly seen alongside polycystic ovarian syndrome. True/False?
True
Outline management of polycystic ovarian syndrome
Ovulation induction
Lifestyle modification
Folic acid 400mcg/5mg if BMI over 30
Check if rubella immunity
By what 3 methods can ovulation be induced in polycystic ovarian syndrome?
Clomifene citrate/tamoxifen/letrozole
Gonadotrophin injection
Laparoscopic ovarian diathermy
What type of drugs are clomifene citrate and tamoxifen?
Anti-oestrogens (thus help stimulate FSH)
Is metformin useful in ovulation induction? If so, why?
Yes
Improves insulin resistance, thus reducing androgen production
What are the main risks of ovulation induction?
Ovarian hyperstimulation
Multiple pregnancy
Possible ovarian cancer
What is another name for ovarian failure?
Hypergonadotrophic hypogonadism