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22 Cards in this Set
- Front
- Back
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What are 3 definitions of Amenorrhea?
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1. No period by age 14 with absence of growth and secondary sex characteristics
2. No period by age 16 regardless of the presence of normal growth and development or secondary sex characateristics. 3. No period for a length equivalent to at least 3 previous cycle intervals, or 6 mos. |
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What are the two categories of amennorrhea classically and what the diff?
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Primary - having never had normal periods
Secondary -after previously regular cycles |
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What is the 4 compartment classificication of amenorrhea?
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Outflow tract
Ovary Anterior Pituitary Hypothalamus |
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What is oligomenorrhea?
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Greater than 35 day cycle
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What is polymenorrhea?
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Less than 21 day cycles
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What is Menorrhagia?
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Normal interval excess flow and duration.
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What is Metrorrhagia?
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Irregular intervals and flow and duration.
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Hormonally how would failure of the Hypothalamus-Pituitary axis manifest?
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Low FSH, LH and estradiol
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Hormonally how would dysfunction of the Hypothalamus-Pituitary axis manifest?
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Normal FSH, LH and estradiol
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Hormonally how would ovarian failure manifest?
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Increased LH and FSH with decreased estradiol.
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Hormonally how would pre-pubery, stress, excess exercise manifest?
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Decreased FSH, LH and E2. (same as H-P failure)
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Hormonally how would anovulation/PCOS manifest?
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Normal FSH, LH and E2
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What are two broad categories of amenorrhea?
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Hypogonadal
Eugonadal -by measurin estrogen |
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What are two categories for Hypogonadal?
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Hypergonadotropic
Hypogonadotropic -determine by measuring FSH (LH) |
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What are two categories for hypergonadotropic?
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Normal chromosomes (PrematureOvarian Failure)
Abnormal chromosomes (Swyer syndrome 46 XY.....) |
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What are two categories of hypogonadal hypogonadotropic amenorrhea?
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MRI abnormal
-prolactinoma, craniopharyngioma MRI normal -anorexia, stress, primary hypothyroidism, exercise -genetic -Kallman syndrome....IHH |
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What are two categories for eugonadal amenorrhea?
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Chronic Anovulation -PCOS, Insulin resistance
Outflow tract abnormality -Imperforate hymen, transverse vaginal septum, mullerian agenesis, androgen resistance, Asherman's syndrome |
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What are some treatments for H-P failure?
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Normalize predisposing factors (stress, exercise, weight)
Pulsatile GnRH Gonadotropin |
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What are some treatment for H-P dysfunction?
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1. Correct underlying cause (hyperprolactinemia, hypothyroidism)
2. Lifestyle modification 3. Clomiphene citrate (clomid) 4. Metformin 5. Aromatase inhibitor 6. Laprascopic ovarian drilling 7. Gonadotropins |
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What are some treatment for ovarian failure?
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1. Health issues
2. IVF with donor oocytes |
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What are 6 causes of outflow tract obstruction?
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1. Labial fusion
2. Imperforate hymen 3. Transverse vaginal septum 4. Cervical stenosis 5.Asherman's syndrome (Intrauterine adhesions) 6. Mullerian agenesis |
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What are some potential causes of hyperprolactinemia?
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1. Prolactin inducing drugs (psychotropic)
2. Hypothyroidism 3. Pituitary tumor |
