Ovulatory Disorders

Question 1

how long is the normal menstrual cycle?

Answer 1

28-35 days

Question 2

if someone has oligomenorrhea, how long do menstrual cycles last?

Answer 2

over 35 days

Question 3

what is the difference between primary and secondary amenorrhoea?

Answer 3

primary = never had a period before 16 years old

secondary = not had a period for 6 months in someone who has had a period before

Question 4

what is another name for an ovulatory disorder caused by hypothalamic pituitary failure?

Answer 4

hypogonadotropic hypogonadism

Question 5

which syndrome is associated with hypogonadotropic hypogonadism?

Answer 5

kellman’s syndrome

Question 6

outline management of hypogonadotropic hypogonadism

Answer 6

pulsatile GnRH 
gonadotropin injections 
stabilise weight (BMI over 18.5)

Question 7

what is the most common ovulatory disease caused by hypothalamic pituitary dysfunction?

Answer 7

polycystic ovarian syndrome

Question 8

what is the criteria for diagnosing polycystic ovarian syndrome?

Answer 8

oligo/amenorrhoea
polycystic ovaries on USS
hyperandrogenism

Question 9

true or false: insulin resistance is commonly seen alongside polycystic ovarian syndrome

Answer 9

true

Question 10

outline management for polycystic ovarian syndrome

Answer 10

ovulation induction
lifestyle modification
folic acid 5mg if BMI over 30
check if rubella immunity

Question 11

what three methods can be used to induce ovulation in polycystic ovarian syndrome?

Answer 11

clomiphene citrate
gonadotropin injection
laparoscopic ovarian diathermy

Question 12

what type of drugs are clomiphene citrate and tamoxifen?

Answer 12

anti oestrogens

help stimulate FSH

Question 13

is metformin useful in ovulation induction?

Answer 13

yes

improves insulin resistance thus reducing androgen production

Question 14

what are the main risks of ovulation induction?

Answer 14

ovarian hyperstimulation
multiple pregnancy
possible ovarian cancer

Question 15

what is another name for ovarian failure?

Answer 15

hypergonadotropic hypogonadism

Question 16

true or false: oestrogen levels are low in ovarian failure

Answer 16

true

Question 17

list some causes of premature ovarian failure

Answer 17

turner syndrome
XX gonadal agenesis
autoimmunity

Question 18

what is involved in a progesterone challenge test?

Answer 18

should menstrual bleed in response to a 5 day course of progesterone to indicate normal oestrogen levels

Question 19

list clinical features of polycystic ovarian syndrome

Answer 19

hirsutism
acne and oily skin
central obesity
amenorrhoea

Question 20

what are the two main anti-oestrogen drugs?

Answer 20

clomiphene citrate

tamoxifen

Question 21

what do aromatase inhibitors do?

Answer 21

inhibit ovarian aromatase enzyme to inhibit oestrogen

Question 22

name an aromatase inhibitor

Answer 22

letrozole