postpill amenorrhoea

Question 1

task

Answer 1

Your patient is a 30-year-old woman who is taking the oral contraceptive pill (OCP). She has
come to see you in a general practice because she did not have a period following the last two
courses of pills
YOUR TASKS ARE TO:
* Take a further focused history.
* Ask the examiner about the findings you wish to elicit on general and gynaecological
examination.
* Advise the patient of the diagnosis and subsequent management (including any
investigations you would arrange)

Question 2

questions

Answer 2

-married? how long have you been on OCP?2years
-first menst: regular?amount?
-after starting OCP
-what OCP>micrognym 30, was it normal>yest at first then later period only one day with scanty bleed>then no period last two days
-SEXUAL HX
frequency, active?
-PREGNANCY SYMPTOM
breast engoregemne, nipple tender, nausea, vomiting
-RELAVANET PMHX, SXH, CURRETAGE

Question 3

Examination

Answer 3

General and abdominal examination:
normal
Speculum examination: normal
Pelvic vaginal examination: uterus retroverted and of normal size and
mobility
Adnexae: normal

Question 4

Advice

Answer 4

-diagonis potpill amenorrhoea due endometrial atrophy.
-no real problem, except for anxiety
-period and fertility return to normal after stopping
-pregnancy unlikely bur hcg should be done
2MX
-increase oestrogen micrognym 50 or triphasic pill increase menstrual loss
-break from pill but use other methods