amenorrhoea Flashcards
(22 cards)
what are the 2 types of amenorrhea
primary
secondary
who does primary amenorrhea refer to
young girls who have never had a period
what are the 2 ways to diagnose primary amenorrhea
1) 13y and no primary sexual characteristics eg body hair
2) 15 and over with no secondary sexual characteristics eg pubic hair, acne, deep voice
2 types of primary amenorrhea
hypergonadotrophic
hypogonadotrophic
what are hormone levels in hypergonadotrophic amenorrhea
high LH
high FSH
what are hormone levels in hypOgonadotrophic amenorrhea
low LH
low FSH
what causes hypergonadotrophic amenorrhea
stimulation of pituitary gland because of abnormal functioning of gonads
what diseases does hypergonaotrophic amennorhea occur in
- turners syndrome (45X)
- ovarian dysgnesis / agenesis
what causes hypogonadotrophic amenorrhea
low GnRH from hypothalamus so no stimulation of ovaries
what does hypogonadotrophic amenorrhea occuri in
- Kallman syndrome (delayed puberty, anosmia)
- failure to thrive
- androgen insensitivity syndrome
who does secondary amenorrhoea refer to
a woman who has had at least 6 months of no period but has previously been menstruating
3 main causes of secondary amenorrhea
- sheehans
- ashermanns
- other
what are the ‘other’ causes of secondary amenorrea
- eating disorders
- hyperthyroidism
- hyperprolactinaemia
- pcos
- pregnancy
- perimenopause
4 diagnistoc methods for amenorrhea
- bimanual exam
- sex bloods
- other bloods
- urinary BHCG
what do u do on bimanual exam for amenorrhea
check if uterus is palpable
what are sex bloods
eostrogen
progesterone
testosterone
FSH
LH
prolactin
sex hormone binding globulin (SHBG)
what are the other bloods for amenorrhea
TFT
IGF1
Hba1c - to rule out PCOS
why do u do urinary BHCG for amenorrhea
to rule out pregnancy
treatment for primary hypo amenorrhea
COCP - provides oestrogen and progesterone
treatment for primary hyper amenorrhea
GnRh analogue
suppresses HPG axis so less LH&FSH
treatment for secondary amenorrhea
refer to secondary care and treat underlying cause
