QuizMe 5

Secondary Amenorrhea

A 23-year-old woman with BMI 33 kg/m2 is referred to the gynaecology clinic with secondary amenorrhea for the last 9 months .She has been complaining of acne and dark pigmentation on her neck. What do you think is her problem? 

  • Secondary Amenorrhea
  • Obese
  • Acne and dark pigmentation

Polycystic Ovary Syndrome (PCOS)

Ultrasound and hormonal panel

Normal uterus

 Both ovaries showing typical polycystic appearance

What is the next management step?

  • Metformin
  • Induction of  ovulation with clomiphene citrate
  • Reassurance  her
  • Endometrial biopsy
  • Withdrawal bleeds with progestogens  

Withdrawal bleeds with progestogens  

Polycystic Ovary Syndrome (PCOS) management depend on the symptoms the patient complains of and their perspective of what is troublesome and requires management.

 However, PCOS may predispose to endometrial hyperplasia and later carcinoma. It is recommended to treat with progestogens to induce a withdrawal bleed at least every 3 to 4 months.

Thickened endometrium or polyp on ultrasound will require further biopsy testing.