Small Group: Reproductive Health Cases – Amenorrhea, Menopause, and HRT

Question 1

What disorders should you consider in a patient with amenorrhea?

Answer 1

•If she has had periods before:

• Pregnancy
• Premature ovarian failure
• Autoimmune destruction of the ovaries
• Prolactinoma
• Hypothyroidism
• Obesity-related anovulation
• Virilizing tumors

• If she has never had a period:

• Turner syndrome
• Disorders of sex development

Question 2

Remember: the main difference between PCOS and obesity anovulation syndrome is _____________.

Answer 2

that PCOS presents with an LH:FSH ratio greater than 2.5

Question 3

What test can help diagnose premature ovarian failure?

Answer 3

If progesterone does not produce a period

Question 4

In PCOS, _______________ will produce a period.

Answer 4

progesterone

Question 5

What is thought to initiate puberty?

Answer 5

Withdrawal of the CNS inhibition of GnRH secretion

Question 6

In what way does estrogen deficiency affect sleep?

Answer 6

It increases the latency to sleep onset.

Question 7

Some research suggests that women who take prolonged hormone replacement therapy after menopause are at decreased risk of __________________.

Answer 7

developing Alzheimer’s

Question 8

In general, hormone therapy should only be offered to ______________ women.

Answer 8

symptomatic

Question 9

Which progestin seems to confer the most cardiovascular risk?

Answer 9

Medroxy-progesterone

Question 10

The only FDA-approved non-hormonal therapy for menopause is _______________.

Answer 10

paroxetine