1 / 51

Amenorrhea Anovulation

Amenorrhea. Transient, intermittent, or permanentResults from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina . Primary vs. Secondary Amenorrhea . Primary: Absence of menarche by the age of 16.Secondary: absence of menses for more than three cycle intervals or six months

derron
Télécharger la présentation

Amenorrhea Anovulation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Amenorrhea & Anovulation Andrea Chymiy, MD Swedish Family Medicine

    2. Amenorrhea Transient, intermittent, or permanent Results from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina

    3. Primary vs. Secondary Amenorrhea Primary: Absence of menarche by the age of 16. Secondary: absence of menses for more than three cycle intervals or six months in women who were previously menstruating

    4. Causes of Primary Amenorrhea Chromosomal abnormalities 45% Physiologic delay of puberty 20% Mllerian agenesis 15% Transverse vaginal septum or imperforate hymen 5% Absent hypothalamic production of GnRH - 5% Anorexia nervosa 2% Hypopituitarism 2%

    5. Diagnostic Evaluation for Primary Amenorrhea: Normal pubertal development? Was pts neonatal/childhood health normal? Family history of delayed/absent menarche? Any symptoms of virilization? Any galactorrhea? (hyperprolactinemia)

    6. More history questions Any recent increase in stress, or change in weight, diet, or exercise habits? Is pt taking any meds or drugs? Short stature compared to family members? Any symptoms of other hypothalamic-pituitary disease (headaches, visual field defects, fatigue, polyuria or polydipsia?)

    7. Physical Exam: Evaluation of pubertal development - including height, weight, & Tanner staging. Pelvic exam to check for presence of cervix, uterus, ovaries (may need ultrasound) Check skin for signs of androgen excess (acanthosis nigras, hirsutism, acne, & striae) and vitiligo (thyroid disorders) Check for physical features of Turner syndrome (low hair line, web neck, shield chest, and widely spaced nipples)

    8. Tanner staging

More Related