Ovulatory Disorders Flashcards
how long is the normal menstrual cycle?
28-35 days
if someone has oligomenorrhea, how long do menstrual cycles last?
over 35 days
what is the difference between primary and secondary amenorrhoea?
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
what is another name for an ovulatory disorder caused by hypothalamic pituitary failure?
hypogonadotropic hypogonadism
which syndrome is associated with hypogonadotropic hypogonadism?
kellman’s syndrome
outline management of hypogonadotropic hypogonadism
pulsatile GnRH gonadotropin 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/amenorrhoea
polycystic ovaries on USS
hyperandrogenism
true or false: insulin resistance is commonly seen alongside polycystic ovarian syndrome
true
outline management for polycystic ovarian syndrome
ovulation induction
lifestyle modification
folic acid 5mg if BMI over 30
check if rubella immunity
what three methods can be used to induce ovulation in polycystic ovarian syndrome?
clomiphene citrate
gonadotropin injection
laparoscopic ovarian diathermy
what type of drugs are clomiphene citrate and tamoxifen?
anti oestrogens
help stimulate FSH
is metformin useful in ovulation induction?
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?
hypergonadotropic hypogonadism
true or false: oestrogen levels are low in ovarian failure
true
list some causes of premature ovarian failure
turner syndrome
XX gonadal agenesis
autoimmunity
what is involved in a progesterone challenge test?
should menstrual bleed in response to a 5 day course of progesterone to indicate normal oestrogen levels
list clinical features of polycystic ovarian syndrome
hirsutism
acne and oily skin
central obesity
amenorrhoea
what are the two main anti-oestrogen drugs?
clomiphene citrate
tamoxifen
what do aromatase inhibitors do?
inhibit ovarian aromatase enzyme to inhibit oestrogen
name an aromatase inhibitor
letrozole
