2 - Gynae - Menstrual Cycle and its disorders - Amenorrhea + Oligomenorrhea Flashcards Preview

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Flashcards in 2 - Gynae - Menstrual Cycle and its disorders - Amenorrhea + Oligomenorrhea Deck (10):
1

what is primary amenorrhea? may be ? or ?
what is secondary amenorrhea?
what is oligomenorrhea?

-menstruation hasn't started by 16 - could be delayed puberty (2' sex char not present by 14), or menstrual outflow problem
-when prev normal menstruation ceases for more 6m or more
- menstruation occurs every 35d-6m

2

Physiological causes???

preg
after menopause
usually during lactation
constitutional delay common and often familial

3

pathological causes?

2' amen/olig most commonly caused by:

drugs eg progestogens, GnRH analogues and antipsychotics
MAY LIE IN:
-hypothalamus, pituitary, thyroid, adrenals, ovary or uterus and outflow tract

PCOS, premature menopause, hyperprolactinaemia

4

Hypothalamus
-what is common? due to 3 things?
-what is uncommon? how to r/o?
-what happens if hypothalamus is cause?
-supportive trt - 3 things?

hypothalamic hypogonadism - physiology, low weight/anorexia or XS exercise

-tumours - w MRI
-GnRH, LH, FSH, and oestradiol reduced
-monitor bone density, HRT/COCP, psych trt if needed

5

Pituitary
- what happens? due to ? or ?
- what are rare?
- trt? 3 things

rare - pituitary tumours, sheehan's necrosis
-hyperprolactinaemia from pit hyperplasia or benign adenomas
-trt - bromcriptine, cabergoline or sugery

6

adrenal or thyroid
- what causes amenorrhea here? 2 things
- 2 rare things

rare things - CAH, virilising tumours

hyperthyroid > amenorrhea
hypothyroid > high prolactin and amenorrhea

7

Ovary - acquired
- what condition? causes what? ass w what? premature menopause in?/100?

PCOS - common - ass w subfertility and long term complx
1' or 2' amenorrhea but olig more common
prem men in 1/100

8

Ovary - congenital
-most commonly? gives normal ?, poor ?, short ?
-effect on ovary?

turners - one X Chr absent - short stature, poor 2' sex characteristics, normal intelligence

gonadal dysgenesis - imperfect ovary formed

9

Menstrual flow obstructed or absent
- acquired? causing? type of amenorrhea?

- usually 2' amenorrhea, cervical stenosis -> haematometra

10

Menstrual flow obstructed or absent
-congenital - type of amenorrhea? normal what? what obstructs flow?
-what happens to blood?
-trt?
-rare?

-1' amenorrhea, normal 2' sex chars
-imperforate hymen and transverse vaginal septum
-rare - absent vagina
-blood pools in vagina (haematocolpos) or in uterus (haematometra)
-trt is surgical

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