Amenorrhea
Define primary amenorrhea.
Failure to achieve menarche by age 15 years, or >3 years after thelarche.
How long of bleeding is considered prolonged?
Bleeding longer than 8 days
Define primary dysmenorrhea.
Menstrual pain without pelvic disease, related to prostaglandin release during ovulation.
What are classic signs of hyperandrogenism in PCOS?
Hirsutism or acne
Define Menorrhagia.
Heavy bleeding.
Define secondary amenorrhea.
Cessation of menses for 3 or more months after menarche.
First-line treatment for heavy bleeding with anemia.
Combined OCP's and iron
First-line treatment for dysmenorrhea.
NSAIDs (ibuprofen, naproxen).
What metabolic risk is PCOS associated with?
Insulin resistance and increased risk of type 2 diabetes/metabolic syndrome.
Define Metrorrhagia.
Irregular bleeding
Name two common causes of secondary amenorrhea in adolescents.
Pregnancy, functional hypothalamic amenorrhea, PCOS, thyroid disease, and chronic illness.
Name a bleeding disorder associated with menorrhagia.
Von Willebrand disease
Which hormone cascade is associated with primary dysmenorrhea pain?
Prostaglandins triggered by ovulation.
Which medication lowers insulin resistance in PCOS?
Metformin
What risks are associated with functional hypothalamic amenorrhea?
Low bone density due to hypoestrogenism.
Which syndrome is associated with anosmia and amenorrhea?
Kallman syndrome
What is the most common cause of abnormal uterine bleeding in
adolescents?
Anovulatory abnormal uterine bleeding due to immaturity of feedback loop.
What should be considered if pain persists despite 3–6 months of OCPs?
Endometriosis
Define the diagnostic criteria for PCOS.
Rotterdam 2003 Criteria
2 of 3 required:
Oligo- or anovulation
Clinical or biochemical hyperandrogenism
Polycystic ovaries on ultrasound (≥12 follicles or increased ovarian volume)
Cyclic pain + midline mass + bulging purple hymen = ?
Imperforate hymen
What is the first test in evaluating amenorrhea?
All women that have periods should be on what supplement?
Iron
Define secondary dysmenorrhea.
Menstrual pain caused by an underlying pathologic condition rather than the normal prostaglandin cascade of ovulation.
What type of cancer are you higher risk for if you have PCOS?
Endometrial cancer
Which amenorrhea condition is associated with short stature and webbed neck?
Primary due to gonadal dysgenesis associated with Turner Syndrome