Secondary amenorrhea

Question 1

Causes

Answer 1

1-Pregnancy
2-PCOS
3-An Ovulation
.hypothyroid
.pit.adenoma
.high prolactin
.drugs like antipsychotic and antidepressants
4-estrogen deficiency
.absence of functional follicle
.hypothalamic pit. Insufficiency
5- outflow tract obstruction
6- weight loss >75% of body weight
7- exercise
8- anorexia nervosa
9- post pill amenorrhea

Question 2

Investigation For secondary amenorrhea

Answer 2

1-BhcG
2-TSH
3-Prolactin
4- progesterone challenge
7 day of progesterone if withdrawl bleed test positive
If no bleed indicate no estrogen priming do
Estrogen progesterone challenge
21 day estrogen and 7 day progesterone
- ve test indicate obstruction
+ve test indicate estrogen deficiency check for FSH