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Flashcards in Ovulatory Disorders Deck (21)
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1

How long is the normal menstrual cycle?

28-35 days

2

If someone has oligomenorrhoea, how long do menstrual cycles last?

Greater than 35 days

3

What is the difference between primary and secondary amenorrhoea?

Primary: never had a period before 16yrs old
Secondary: not had a period for 6mths in a person who has had a period before

4

What is another name for an ovulatory disorder caused by hypothalamic pituitary failure?

Hypogonadotrophic hypogonadism

5

Which syndrome is associated with hypogonadotrophic hypogonadism?

Kallman's syndrome

6

Outline management of hypogonadotrophic hypogonadism

Pulsatile GnRH
Gonadotrophin injections
Stabilise weight (BMI over 18.5)

7

What is the most common ovulatory disease caused by hypothalamic pituitary dysfunction?

Polycystic ovarian syndrome

8

What is the criteria for diagnosing polycystic ovarian syndrome?

Oligo/amen -orrhoea
Polycystic ovaries on USS (12+ 2-9mm follicles)
Hyperandrogenism

9

Insulin resistance is commonly seen alongside polycystic ovarian syndrome. True/False?

True

10

Outline management of polycystic ovarian syndrome

Ovulation induction
Lifestyle modification
Ovulation induction
Folic acid 400mcg/5mg if BMI over 30
Check if rubella immunity

11

By what 3 methods can ovulation be induced in polycystic ovarian syndrome?

Clomifene citrate/tamoxifen/letrozole
Gonadotrophin injection
Laparoscopic ovarian diathermy

12

What type of drugs are clomifene citrate and tamoxifen?

Anti-oestrogens (thus help stimulate FSH)

13

Is metformin useful in ovulation induction? If so, why?

Yes
Improves insulin resistance, thus reducing androgen production

14

What are the main risks of ovulation induction?

Ovarian hyperstimulation
Multiple pregnancy
Possible ovarian cancer

15

What is another name for ovarian failure?

Hypergonadotrophic hypogonadism

16

Oestrogen levels are low in ovarian failure. True/False?

True

17

List some causes of premature ovarian failure (menopause before age of 40)

Turner syndrome
XX gonadal agenesis
Autoimmunity

18

What is involved in a progesterone challenge test?

Should menstrual bleed in response to a 5-day course of progesterone to indicate normal oestrogen levels

19

List clinical features of polycystic ovarian syndrome

Hirsutism
Acne/oily skin
Central obesity
Amenorrhoea

20

What are the 2 main anti-oestrogen drugs?

Clomifene citrate
Tamoxifen

21

What do aromatase inhibitors do? Give an example of one

Letrozole
Inhibit ovarian aromatase enzyme to inhibit oestrogen