Menstrual Disorders 1 and 2 Flashcards
What is secondary amenorrhea?
-absence of menstruation x6 months
What do we check first for secondary amenorrhea?
-TSH and prolactin levels
What is the difference between micro and macroadenomas and how do we treat them?
- > or< 10mm
- treat with bromocriptine
What prolactin level will make us suspicious for pituitary adenoma or empty sella syndrome?
-PRL> 100ng/mL
What do we do if there is normal TSH and prolactin?
-Progesterone challenge test (PCT)
What is nonclassic congenital adrenal hyperplasia?
- elevated 17 hydroxyprogesterone
- do not present with genital abnormalities
PCOS
- elevated insulin and androgen levels reduce the hepatic production of sex hormone binding fglobulins
- leads to incrase in circulating testosterone
- needs 2 of the 3 things: oligomenorrhea or amenorrhea, LH:FSH ratio 2:1, and U/S revealing multiple small cysts beneath the cortex of the ovary
What is our big worry with chronic anovulation?
-increases risk for endometrial cancer because of unopposed Estrogen
What is one of the key physical findings for someone with hyperandrogenism?
-acanthosis nigricans
Primary amenorrhea definition
-no menstruation by 13 y/o without secondary sexual development OR by the age of 15 with secondary sexual characteristics
Secondary amenorrhea
-absence of menses for 6 months or more
Polymenorrhea
-abnormally frequent menses at intervals at <21 days
Menorrhagia
-excessive and/or prolonged bleeding occurring at normal intervals
Metrorrhagia
-irregular episodes of uterine bleeding
menometrorrhagia
-heavy and irregular uterine bleeding
