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afya
Amenorrhoea
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> divide into primary (no menses by 16y) or secondary (cessation of established, regular menstruation for 6/12+) ''Causes of primary amenorrhoea'' Turner's syndrome testicular feminisation congenital adrenal hyperplasia congenital malformations of the genital tract ''Causes of secondary amenorrhoea (after excluding pregnancy)'' hypothalamic amenorrhoea (e.g. Stress, excessive exercise) polycystic ovarian syndrome (PCOS) hyperprolactinaemia premature ovarian failure thyrotoxicosis (or hypothyroid) ''Initial investigations'' exclude pregnancy with urinary or serum bHCG gonadotrophins - (low - hypothalamic, high - ovarian eg POF) prolactin androgen levels - eg PCOS oestradiol (progesterone doesn't help) thyroid function tests
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