{"id":127,"date":"2017-03-23T18:37:58","date_gmt":"2017-03-23T18:37:58","guid":{"rendered":"http:\/\/papergp.com\/index.php\/womens-health\/amenorrhoea\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"amenorrhoea","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/womens-health\/amenorrhoea\/","title":{"rendered":"Amenorrhoea"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Primary\n<ul>\n<li>No periods by the age of 16 (or 14 if no secondary sexual characteristics)<\/li>\n<\/ul>\n<\/li>\n<li>Secondary\n<ul>\n<li>PCOS &#8211; acne, hirsutism<\/li>\n<li>Prolactinoma &#8211; headache, visual changes, galactorrhoea<\/li>\n<li>Pregnancy &#8211; LMP<\/li>\n<li>Weight loss &#8211; exercise, stress<\/li>\n<li>Premature ovarian failure &#8211; hot flushes, vaginal dryness<\/li>\n<li>Others &#8211; thyroid, medications<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; see prolactinoma, ovarian failure<\/li>\n<li>Others &#8211; ever had period, pregnancy, abdo pain, hot flushes, vaginal dryness, weight change, diet, exercise, stress<\/li>\n<li>Examination &#8211; BMI, secondary sexual characteristics, visual fields<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; TFTs, LH, FSH, prolactin, HbA1c, testosterone, SHBG<\/li>\n<li>Pregnancy test<\/li>\n<li>USS pelvis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>several reasons inc hormonal changes (from pregnancy, menopause, breastfeeding), contraception, surgery, medical condition (e.g. thyroid)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Primary\n<ul>\n<li>refer if no periods by 14 years old (and no breasts\/pubic hair) otherwise by 16 years old<\/li>\n<\/ul>\n<\/li>\n<li>Secondary\n<ul>\n<li>treat underlying cause, refer if cause not established<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net &#8211; PIL\n<ul>\n<li>Consider referral if persisting &gt; 6 months<\/li>\n<li>Delay investigation until 9 months if obvious cause e.g. active sports person<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Primary No periods by the age of 16 (or 14 if no secondary sexual characteristics) Secondary PCOS &#8211; acne, hirsutism Prolactinoma &#8211; headache, visual changes, galactorrhoea Pregnancy &#8211; LMP Weight loss &#8211; exercise, stress Premature ovarian failure &#8211; hot flushes, vaginal dryness Others &#8211; thyroid, medications &nbsp; Data gathering Red flags &#8211; see &hellip; <a href=\"https:\/\/papergp.com\/index.php\/womens-health\/amenorrhoea\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Amenorrhoea<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":122,"menu_order":104,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-127","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=127"}],"version-history":[{"count":14,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/127\/revisions"}],"predecessor-version":[{"id":1962,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/127\/revisions\/1962"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/122"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}