Obgyn: Amenorrhea: Free MSRA Podcast

🎧FREE MSRA PODCAST –Amenorrhoea: Master the Approach, Causes, and ManagementStruggling to memorise amenorrhoea? Today we’rebreaking down one of the most fundamental gynaecology topics for the MSRA: howto define, investigate, and manage the absence of periods. This episodetransforms dense notes into practical, high-yield knowledge! 📝Key Learning Points📌Definition &Subtypes• Amenorrhoea = absence of menstruation• Primary: No period by age 15 (with secondarysexual characteristics) OR by age 13 (without secondary sexual characteristics)• Secondary: Cessation of menstruation for ≥3–6months if regular cycles before, or ≥6–12 months if irregular cycles📌First Steps• Always exclude physiological causes first: – Pregnancy – Breastfeeding – Contraceptive use(pill, injection, implant)📌Causes• Primary: – Gonadaldysgenesis (e.g. Turner syndrome) – Congenitaluterine/vaginal abnormalities (imperforate hymen, Mullerian agenesis) –Hypothalamic/pituitary dysfunction• Secondary: – Most common: pregnancy – PCOS – Hypothalamicamenorrhoea (stress, weight loss, excessive exercise) –Hyperprolactinaemia – Thyroiddysfunction – Premature ovarianfailure (early menopause) – Asherman’ssyndrome (intrauterine adhesions) – Medications,chronic illness📌Risk Factors• Family history,eating disorders, extremes of weight, excessive exercise, psychological stress📌Pathophysiology• Disruption of the HPO axis (hypothalamus-pituitary-ovarian axis)• Structuralabnormalities of reproductive tract📌Diagnosis• Careful history (duration, contraception, hotflushes, stress, weight changes, medications, past medical history)• Examination: BMI, secondary sexualcharacteristics, signs of androgen excess (hirsutism, acne), thyroid orCushing’s features• Investigations: – β-hCG (pregnancytest!) – Hormonal profile:FSH, LH, prolactin, TFTs, testosterone – Pelvic ultrasound(structural/PCOS) –Karyotype/MRI/hysteroscopy if indicated💡Clinical Pearl: Repeat prolactin before MRI – stress, food, andbreast exam can cause temporary rises!📌Management• Depends entirely on cause!• Lifestyle changes(weight, exercise, stress reduction)• Hormonal therapy(COCP, HRT)• Surgery (ifstructural cause)• Address underlyingendocrine issues (thyroid, prolactin)• Bone protection(calcium, vitamin D, OCP/HRT if prolonged amenorrhoea)• Fertility referralif desired📌Complications &Prognosis• Fertility problems• Osteoporosis (due to low oestrogen)• Psychological distress• Prognosis dependson cause and how quickly treated 📎More AmenorrhoeaRevision Resources:📝 Revision Notes: https://www.passthemsra.com/topic/amenorrhoea-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/amenorrhoea-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/amenorrhoea-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/amenorrhoea-rapid-quiz/🧪 Quiz Bank: https://www.passthemsra.com/quizzes/amenorrhoea/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/#MSRA #Amenorrhoea#Amenorrhea #MSRARevision #Gynaecology #ObsAndGynae #PCOS #PassTheMSRA