Ovarian Pathology/ Fertility/ Amenorrhoea

Question 1

What is secondary amenorrhea?

Answer 1

Absence of menses for over 6 months in a women with established menstruation

Question 2

What are possible causes of primary amenorrhea?

Answer 2

• Delayed puberty (no signs of puberty by age 13)
• Imperforate hymen or other genital malformations
• Excessive exercise which can suppress hypothalamic GnRH production, or other hypothalamic disorder
• Turner syndrome

Question 3

What are causes of secondary amenorrhea?

Answer 3

Pregnancy
Menopause
Failure of some part of hypothalamic, pituitary, ovarian, uterine axis eg PCOS
Metabolic disturbance
Weight loss below 75% of ideal

Question 4

What is primary amenorrhea?

Answer 4

Failure of menses to start by 16 years

Question 5

At what age is the peak incidence of ovarian cancer?

Answer 5

60-65

Question 6

What are risk factors for ovarian cancer?

Answer 6

Age
Family history (first degree relatives)
Nulliparity

Question 7

What are protective factors for ovarian cancer?

Answer 7

OCP

Pregnancy

Question 8

What are clinical features of ovarian tumours?

Answer 8

Constitutional symptoms: fatigue, anorexia
Lower abdominal discomfort
Abdominal bloating and ‘fullness’
GIT dysfunction ed epigastric discomfort, diarrhoea, constipation
Genitourinary symptoms eg frequency, urgency, prolapse
+/- abnormal uterine bleeding
Dyspareunia and/ or dysmenorrhea
+/- weight loss

Question 9

What are symptoms of PCOS?

Answer 9

Infertility
Oligomenorrhoea
Hirsutism
Obesity
Cystic ovaries
Acne