PathophysI_MDO_October1_2012_CaseDiscussion_Post (1)

Pregnancy hypothalamic suppression chronic

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pregnancy, hypothalamic suppression, chronic anovulation, hyperprolactinemia, ovarian failure, uterine disorders Clinical manifestations / course Impact on QOL via hypoestrogenism Negative impact on bone mineral density
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Amenorrhea - Pathophysiology Hypothalamic-pituitary-ovarian (HPO) axis evaluation Ovaries: lack of/early loss of ovarian follicles; genetic abnormalities; toxins Anterior pituitary: prolactin-secreting adenoma; thyroid releasing hormone contributing to increased prolactin levels Hypothalamus: reduction in GnRH (eating disorders, extreme endurance activities)
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Menorrhagia Definition: menstrual blood loss greater than 80 mL per cycle Contributing factors / pathophysiology Systemic disorders: pregnancy, ectopic pregnancy, miscarriage Uterine abnormalities: fibroids, endometrial polyps Bleeding abnormalities: vonWillebrand’s disease; idiopathic thrombocytopenic purpura Cirrhosis Clinical manifestations / course
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Anovulatory Bleeding Definition: dysfunctional or irregular uterine bleeding NOT related to an anatomic lesion of the uterus. 70% of cases are due to PCOS Etiology: immature HPO axis (no LH surge); declining ovarian function; hyperprolactinemia; high thyroid stimulating hormone (TSH); high FSH; hyperandrogenism Clinical manifestations / course
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Definition Hyperandrogenism and chronic anovulation in cases in which secondary causes have been
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pregnancy hypothalamic suppression chronic anovulation...

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