Secondary Amenorrhea Case Review

Flashcards reviewing the diagnosis and management of secondary amenorrhea based on a patient case.

Amenorrhea (Secondary)

Absence of menstruation for 18 months.

Patient Lab Results

Low FSH, low LH, low estrogen, normal thyroid, normal prolactin.

Period History

Detailed history of previous periods (regularity, duration, cycle length).

Pregnancy Risk

Sexual activity, potential for pregnancy (tiredness, morning sickness, breast tenderness).

Contraception & Obstetric History

Contraception history (types used), previous pregnancies, complications, surgeries (D&C), surgical terminations, breastfeeding, cervical screening.

Hypothalamus Causes

Stress at home/work, exercise habits, dieting habits, laxative use, medications.

Prolactinoma Questions

Headache, blurring of vision, discharge from breasts/nipples.

Medical History Questions

Weather preference, constipation/diarrhea.

PCOS Questions

Acne, excessive hair growth, recent weight gain.

Premature Ovarian Failure Questions

Hot flushes.

General History Questions

Smoking, alcohol, illicit drugs, allergies, relevant past medical history, family history of PCOS/thyroid disease.

Diagnosis Based on Patient History

Diagnosis: Excessive diet and exercise suppressing hypothalamic hormone production (low LH/FSH).

Differential Diagnoses

Stress, pituitary tumors, hypopituitarism, prolactinoma, thyroid problems, PCOS, premature ovarian failure, contraceptive pills, pregnancy, chronic illnesses.

Risks & implications

Infertility, osteoporosis, increased risk of cardiovascular disease, heart attack, and stroke.