Flashcards in Menstrual Disorders Deck (61)
How is primary amnorrhea defined?
Absence of menarche by age 15
How is secondary amenorrhea defined?
Absence of menses for 6 months or greater in a woman previously menstruating
What is the most common chromosomal cause of primary amenorrhea?
What are the FOUR most common manifestations of Turner's Syndrome?
Primary Gonadal Failure
What are THREE structural causes of primary amenorrhea?
Absence of uterus, cervix, vagina
Transverse vaginal septum
The absence of a uterus, cervix, or vagina would result from __________ (mullerian/wolffian) abnormalities
What is another name for the syndrome that results in mullerian agenesis?
Transverse vaginal septums occur from _______ (agenesis/apoptosis) of the vaginal plate
Which is more common.....
Imperforate Hymen or Mullerian Abnormalities
How are sturctural causes of primary amenorrhea managed?
Resection (Imperforate Hymen, Vaginal Septums)
Hysterectomy (Absent Cervix)
Creation of a Neovagina
What are FOUR 'conditions' that may lead to hypothalamic malfunction that results in amenorrhea?
1. Eating Disorders (Anorexia)
2. Vigorous Exercise
3. Low Body Fat
4. High Stress
_________ Syndrome is described as a congenital GnRH deficiency classically associated anosmia
What are TWO causes of ovarian caused primary amenorrhea?
Premature Ovarian Failure
What is the name of the syndrome that results in primary amenorrhea in females and often is associated with the presence of testis in the labia?
Androgen Insensitivity Syndrome
(46 XY with non functional androgen receptors)
When working up primary amenorrhea what labs should you order if a uterus is present?
Present: B-Hcg, FSH, FSH, Prolactin
Absent: Karotype, Serum Testosterone
What is the most common cause of secondary amenorrhea?
What ALWAYS needs to be ruled out when working up secondary amenorrhea?
What are the THREE most common 'sources' for secondary amenorrhea?
T/F: Secondary amenorrhea cannot be iatrogenic
It can be
(ex: OCPs, Metocloparmide, Antipsychotics)
How does functional hypothalamic amenorrhea occur?
Decreased GnRH secretion commonly due to anorexia, low body fat, or excessive exercise
T/F: Celiac disease can impact hypthalamic function leading to secondary amenorrhea
What is the most common pituitary adenoma?
Can secondary amenorrhea result from hypothyroidism or hyperthyroidism?
PCOS is the cause of about __% of amenorrhea
What ovarian disroder is classified as a depletion of functional oocytes before the age of 40?
Premature Ovarian Failure
What is Asherman;s Syndrome?
Acquired scarring of the endometrial lining from prior surgery or infection
What is the first lab always ordered when working up amenorrhea?
If a patient underwent the progestin withdrawal test for secondary amenorrhea and no bleeding occurred what would it indicate?
When working up secondary amenorrhea, why are the following ordered......
MRI: Pituitary Adenoma
Karyotype: If FSH elevated to r/o partial chromosome deletion