Flashcards in Amenorrhoea Deck (55)
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1
What is amenorrhoea?
The absence of menstrual periods
2
How can amenorrhoea be classified?
- Primary
- Secondary
3
What is oligomenorrhoea?
Irregular periods with intervals between menstrual cycles of more than 35 days and/or less than 9 periods per year
4
What is primary amenorrhoea?
Failure to commence menses
5
When can primary amenorrhoea be diagnosed in girls 14+?
In the absence of secondary sexual characteristics
6
When can primary amenorrhoea be diagnosed in girls 16+?
In the presence (or absence) of secondary sexual characteristics
7
What are some examples of secondary sexual characteristics?
- Pubic hair
- Breast development
8
What is secondary amenorrhoea?
When there is cessation of periods for > 6 months after menarche
9
Can causes of secondary amenorrhoea cause primary amenorrhoea?
Almost always, if they are established before menarche
10
What are some specific causes of primary amenorrhoea in the presence of secondary sexual characteristics?
- Constitutional delay
- Genitourinary malformations
- Testicular feminisation (androgen resistance syndrome)
- Hyperprolactinaemia
11
What is constitutional delay of menarche?
Where there is no abnormality but the girl is a little later than her peers in reaching menarche
12
What is a useful part of the history in identifying constitutional delay of menarche?
History of menarche in mother and sisters
13
What genitourinary malformations can lead to primary amenorrhoea in presence of secondary sexual characteristics?
- Imperforate hymen
- Transverse vaginal septum
- Absence of uterus or vagina
14
What karyotype does androgen resistance syndrome occur in?
XY
15
What is the external appearance in androgen resistance syndrome?
Normal adolescent girl
16
What is the internal appearance in androgen resistance syndrome?
No female internal organs and gonads are testosterone producing testes
17
How can the presentation of androgen resistance syndrome vary?
On the degree of androgen sensitivity
18
What can cause hyperprolactinaemia leading to primary amenorrhoea?
- Hypothyroidism
- Medication
- Pituitary tumours
19
What medications can lead to hyperprolactinaemia leading to primary amenorrhoea?
Phenothiazines
20
What can cause primary amenorrhoea in the absence of secondary sexual characteristics?
- Ovarian failure
- Other causes of failure of the HPA
- Causes of ambiguous genitalia
21
What can cause ovarian failure leading to primary amenorrhoea?
- Chemotherapy
- Irradiation
- Chromosomal gonadal abnormality
- Developmental abnormality
22
What chromosomal abnormality can lead to primary amenorrhoea?
Turner's syndrome
23
What developmental abnormality can lead to primary amenorrhoea?
Mullerian agenesis
24
What can cause failure of the HPA leading to primary amenorrhoea?
- Tumours
- Irradiation
- Infection
- Head injury
25
What can cause ambiguous genitalia leading to primary amenorrhoea?
- Androgen secreting tumours
- Congenital adrenal hyperplasia
26
What is the most common cause of secondary amenorrhoea in women of childbearing age?
Pregnancy
27
What are the causes of secondary amenorrhoea with no signs of androgen excess?
- Physiological causes
- Premature ovarian failure
- Depot and implant contraception
- Cervical stenosis and intrauterine adhesions (Asherman's syndrome)
- Hypothalamic dysfunction
- Loss of weight
- Pituitary disease and hyperprolactinaemia
- Thyroid disease
- Iatrogenic
28
What are the physiological causes of secondary amenorrhoea?
- Pregnancy
- Lactation
- Menopause
29
What can be the causes of premature ovarian failure leading to secondary amenorrhoea?
- Autoimmune
- Radiotherapy
- Chemotherapy
30
