TSR wrote:
What is the algorhythm in secondary amenorrhea? There is a discrepency between U.W. and Kaplan.
not that much difference btw them
1. rule out pregnancy, hypothyr, hyperprolactin
2. determine estrogen status - if bleeds after progestin challange tect - stress/anovulation
3. if no bleed - ashermann or menopause/savage - determine FSH and LH for that
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| TSR
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in crush and uw it is given as ;
1.pregnancy test
2.progesterone challenge test
3.if prog test is +ve, then go for prolactin and thyroid
if prog test is _ve, then chcek estrogen status.
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| Destination
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The most common cause of 2 amennorhea is Pregnancy so ist rule out it.If -ive then rule out hypothyroidism and Elevated prolactin levels.then
Do progestrone challange test ,if +ive then cause is anovultaion,if -ive then cause is inadequate estrogen
then next step is Estrogen progesterone Challange Test.+iveEPCT means inadequate estrogens then next step is measure FSH level.Elevated FSH level indicates mena ovarian failure or Resistance ovary syndrome
Low FSH means Hypothalamic pituitary insufficiency
Negative EPCT indicates outflow tract obstruction or endometrial scarring
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