Self-Assessment Questions

31. Secondary amenorrhea

• Define secondary amenorrhea.

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  Correct answer:
  Secondary amenorrhea is defined as the absence of three menstrual cycles or the absence of menstrual bleeding for 6 months.

• What is the most common cause of chronic anovulatory amenorrhea and what is the pathophysiology of this syndrome?

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  Correct answer:
  Polycystic ovary syndrome (PCOS) is the most common case of chronic anovulatory amenorrhea. The pathophysiology can be linked to the combination of exaggerated pulsatile GnRH secretion, causing elevated circulating luteinizing hormone and an increased LH : FSH ratio and defects in insulin signaling for glucose transport and lipolysis, causing insulin resistance.