Amenorrhoea

Question 1

Common causes of amenorrhoea?

Answer 1

PCOS (anovulatory dysfunction)
Premature menopause/premature ovarian failure
Hypothalamic amenorrhoea

Question 2

Presentation of PCOS

Answer 2

Oligomenorrhoea, amenorrhoea, hirsutism, may have high BMI

Question 3

Define premature ovarian failure/premature menopause

Answer 3

Amenorrhoea before the age of 40
Menopausal symptoms

Question 4

Hypothalamic amenorrhoea presentation

Answer 4

Typically extreme weight loss
Low to normal bmi
(anorexia, extreme exercise, famine, stress) leading to amenorrhoea

Question 5

What tests are done in amenorrhoea?

Answer 5

Baseline FSH and LH level
Progesterone withdrawal if not bleeding at all

Question 6

PCOS blood results?

Answer 6

Typically
FSH - normal to low
LH - raised (ovulation not happening)

Question 7

Blood results in premature ovarian failure?

Answer 7

FSH raised (on 2 occasions 4-6 weeks apart)
LH low but rises later on

Question 8

Blood results in hypothalamic amenorrhoea?

Answer 8

Low FSH and low LH

Question 9

US scan findings in PCOS

Answer 9

12 or more small follicles seen in the ovaries

Question 10

US scan findings in premature ovarian failure/ hypothalamic amenorrhoea?

Answer 10

Ovaries appear normal or quiescent

Question 11

When does LH peak?

Answer 11

Ovulation day 14