Amenorrhea Causes & Treatments

Amenorrhea & Anovulation Andrea Chymiy, MD Swedish Family Medicine

Amenorrhea ,[object Object],[object Object]

Primary vs. Secondary Amenorrhea ,[object Object],[object Object]

Causes of Primary Amenorrhea ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic Evaluation for Primary Amenorrhea: ,[object Object],[object Object],[object Object],[object Object],[object Object]

More history questions… ,[object Object],[object Object],[object Object],[object Object]

Physical Exam: ,[object Object],[object Object],[object Object],[object Object]

Typical features of Turner Syndrome

If uterus not found on exam… ,[object Object],[object Object]

If patient does have a uterus… ,[object Object],[object Object],[object Object]

Correcting the underlying pathology ,[object Object],[object Object]

Treatment of PCOS ,[object Object],[object Object],[object Object]

Hypothalamic amenorrhea ,[object Object]

Secondary Amenorrhea ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ovarian causes of amenorrhea ,[object Object],[object Object]

Diagnosing the etiology of secondary amenorrhea ,[object Object]

Pertinent history in work-up of secondary amenorrhea ,[object Object],[object Object],[object Object]

Other important stuff in the history… ,[object Object],[object Object],[object Object]

Physical exam findings ,[object Object],[object Object],[object Object],[object Object]

Initial lab evaluations for secondary amenorrhea ,[object Object],[object Object],[object Object]

High serum prolactin ,[object Object],[object Object],[object Object]

High serum FSH ,[object Object],[object Object],[object Object]

High serum androgen concentrations ,[object Object],[object Object]

Normal or low serum gonadotropin concentrations and all other tests normal ,[object Object],[object Object],[object Object],[object Object]

Normal serum prolactin & FSH with history of uterine instrumentation ,[object Object],[object Object]

Evaluating for Asherman’s syndrome ,[object Object],[object Object],[object Object]

Treatment for functional hypothalamic amenorrhea ,[object Object],[object Object]

Basal BMI vs probability of resumption of menstruation

Treatment for functional hypothalamic amenorrhea ,[object Object],[object Object],[object Object]

Hyperprolactinemia ,[object Object],[object Object]

Treatment of ovarian causes of secondary amenorrhea ,[object Object],[object Object]

Treatment of Asherman’s syndrome ,[object Object]

Case 1: 17 yo female with primary amenorrhea ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 1: Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 1: Further history ,[object Object]

Diagnosis: Hypothalamic Amenorrhea ,[object Object],[object Object],[object Object]

Case 2: 24 yo woman with secondary amenorrhea ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 2: Physical Exam ,[object Object],[object Object],[object Object],[object Object]

Case 2: Laboratory findings ,[object Object],[object Object],[object Object],[object Object]

Case 3: 29 yo woman with 18-month h/o amenorrhea ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 3: Physical Exam ,[object Object],[object Object],[object Object]

Case 3: Laboratory findings ,[object Object],[object Object],[object Object]

Case 3: Further work-up ,[object Object],[object Object],[object Object],[object Object]

Amenorrhea Causes & Treatments

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Amenorrhea Causes & Treatments