Secondary Amenorrhoea Flashcards
1
Q
definition?
A
absence of menstruation > 6 months in a woman who has previously menstruated
2
Q
aetiology?
A
- pregnancy
- menopause
- premature ovarian failure
- PCOS
- hormonal contraception
- hypothalamic / pituitary pathology
- thyroid abnormalities
- asherman’s syndrome
3
Q
outline what hypothalamic / pituitary pathology could cause secondary amenorrhoea
A
- hypothalamus
- reduces GnRH in response to significant physiological or psychological stress
- pituitary tumour or failure
- prolactinoma - hyperprolactinaemia-> inhibits GnRH
4
Q
Ix?
A
- Hormonal blood tests
- bHCG
- FSH, LH
- prolactin
- TFT
- testosterone
5
Q
what would a high FSH suggest?
A
primary ovarian failure
6
Q
Mx?
A
- treat underlying cause
- replacement hormones can induce menstruation
7
Q
what additional management step should be considered?
A
if amenorrhoea >12 months, treatment to reduce risk of osteoporosis should be started (vit d & calcium)
