Module 3 - AUD

Question 1

PCOS

Answer 1

Presents: amenorrhea, weight gain, hirsutism, acne
Treatment:
- First Line: hormonal contraception or progestin IUD
- Lifestyle modifications

Tests:
- TSH, bHCG, Free Testosterone
- LH (higher)FSH: ratio 3:1 shows PCOS
- Prolactin
(remember hyperangronism, hyperprolactemia, hypothyroid)

Question 2

Hirsutism

Answer 2

excess male pattern hair growth

high levels on insulin causes ovaries to produce higher levels of androgen

Question 3

Dysmenorrhea

Answer 3

Treatment: NSAIDS
No wish to conceive: IUD?

Question 4

PMDD

Answer 4

Occurs exclusively during 2 weeks preceding menses

Treatment: SSRI (fluoxetine, sertraline, paroxetine)

Question 5

PMS

Answer 5

Occurs same time every month during luteal phase of menstruation and impacts function and lifestyle

TREATMENT: NSAID and CBT
TESTING: FSH, estradiol, TSH, prolactin, cortisol

Question 6

AUD

Answer 6

Postmenopausal Bleeding
TESTING: transvaginal ultrasound
CONCERN: endometrial cancer
WHATS THE CAUSE OF CYCLE CHANGE: you have estrogen but no ovulation

Young AUB
YOUTHS: oral contraceptives
- most are secondary to the anovulatory cycles as the hypothalamic-pituitary-ovary-axis is not mature
ADULT OVER 45YO:
- endometrial sampling
- imaging is still transvaginal ultrasound

PREGNANTS:
- normal for 3 mo but still warrants pregnancy test
- after 3 mo workup is warranted