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DRCOG MCQs for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Primary amenorrhoea is defined as no menstruation by 14 years of age with absence of secondary sexual characteristics or no menstruation by 16 years of age with normal growth and sexual development. Any cause of secondary amenorrhoea can cause primary amenorrhoea.
Practice exam I: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
Amenorrhoea can be categorized as primary and secondary. Primary amenorrhoea occurs when a girl has never experienced a menstrual period by the age of 16. Secondary amenorrhoea occurs with the absence of periods for more than six months (2).
Medical treatment of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
Intramuscular Depo-Provera® is an alternative to oral medroxyprogesterone acetate. It is more often used for contraception, but has been shown to be effective in inducing amenorrhoea and improving endometriosis-associated pelvic pain. Depo-Provera is as effective as low-dose danazol combined with an oral contraceptive pill, but has far fewer side-effects11. The major side-effects of Depo-Provera include weight gain, breast tenderness. There may be prolonged amenorrhoea following termination of treatment. It is this last side-effect that limits use for women wishing to seek fertility in the short term.
The influence of estro-progestin therapy on neurohormonal activity in functional hypothalamic amenorrhea
Published in Gynecological Endocrinology, 2022
Anna Szeliga, Agnieszka Podfigurna, Gregory Bala, Blazej Meczekalski
Functional hypothalamic amenorrhea (FHA) is a chronic endocrine disorder caused by a disturbance of the pulsatile secretion of hormones in the hypothalamus, which in turn results in suppression of the hypothalamic-pituitary-ovarian axis. Inhibition of pulsatile gonadotropin-releasing hormone (GnRH) secretion in the hypothalamus results in suppression of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion from the pituitary gland. This sequence leads to the suppression of the hormonal and reproductive functions of the ovary [1, 2]. Secondary amenorrhea, which is the most common symptom, is characterized as amenorrhea occurring in a previously menstruating woman. It affects approximately 3-5% of the female population in reproductive age. FHA accounts for 25% to 35% of secondary amenorrhea, making it the most common cause of secondary amenorrhea in our population. At the same time, FHA is known to be the causative agent in only about 3% of primary amenorrhea, ceding to gonadal dysgenesis and polycystic ovary syndrome as leading causes. It is estimated that up to about 17 million women worldwide suffer from FHA [3, 4].
Heterochromatin extension: a possible cytogenetic fate of primary amenorrhea along with normal karyotype
Published in Journal of Obstetrics and Gynaecology, 2022
Bishal Kumar Dey, Shanoli Ghosh, Ajanta Halder, Somajita Chakraborty, Sanchita Roy
Primary amenorrhoea (PA) refers to no menstruation that is found either in the females of age 16 with developing secondary characteristics or in the females of age 14 having no such secondary sexual characteristics. For normal menstruation to occur, proper functioning of hypothalamus–pituitary–ovarian axis as well as intact uterus and appendages are needed. Depending on the anatomical and physiological principles of menstruation, the various aetiological factors of amenorrhoea include hormonal imbalance, anatomical abnormalities, genetic factors and environmental factors. However, chromosomal aberrations, especially of sex chromosome play an important role in PA. Various national and international level of investigations established a relation between chromosomal abnormalities and PA. Chromosomal aberration frequency reported to be ranging from 14% to 60% in PA cases. Among the numerical aberration, Turner syndrome in pure or mosaic form is predominant. Structural aberrations include isochromosome of X, deletions, duplications, ring chromosomes and also translocation between autosome and X chromosome. In number of cases, patient with PA also reveals XY karyotype which may occur when testis determining factor (TDF) or other genes in the testes determining pathway are lost, mutated or compromised or due to testicular feminisation.
Assessment of insulin resistance and metabolic syndrome in young reproductive aged women with polycystic ovarian syndrome: analogy of surrogate indices
Published in Archives of Physiology and Biochemistry, 2022
Nadia Rashid, Aruna Nigam, Sana Kauser, Prem Prakash, S. K. Jain, Saima Wajid
Study subjects included women of age group 16–35 years attending the outpatient department (OPD) of Gynaecology and Obstetrics, HAH Centenary Hospital, Jamia Hamdard, New Delhi from August 2014 to September 2016 with menstrual and infertility complaints. Subjects fulfilling the Rotterdam criteria (2004) were recruited into the PCOS group (n = 95). Clinical hyperandrogenism was defined by the presence of hirsutism (modified Ferriman–Gallwey score of ≥8) whereas biochemical hyperandrogenism was defined by increased levels of total/free testosterone levels. In 20–35 years old females, cut-off points for hyperandrogenaemia (the 95th percentiles): serum level of total testosterone (T) – 1.68 nmol/L, dehydroepiandrosterone sulphate (DHEAS – 10.42 mmol/L, free androgen index (FAI)) – 2.94. Amenorrhoea was defined as per FIGO guidelines as the absence of menstrual bleeding for a period of 90 days. Oligo-ovulation was defined by the presence of menstrual cycles of >35 days in length or less than 6–9 menstrual cycles in a year whereas anovulation was defined by complete absence of at least six menstrual cycles. Polycystic ovarian morphology was defined by the presence of ≥12 antral follicles measuring 9–12 mm in diameter in one/both ovaries and/or ovarian volume of ≥10 cm3 with increased stromal echogenicity.