investigations done diagnose plz
13 years old obese female child she had spotting in may then amenorrhea of 6 months ..may be irregular periods which are common in the beginning now she has bledding when she passes urine only ..after stream of urine is over then 2-3 drops of blood come..no bleed at other times diagnosis plzz no pain abdomen no back ache
usg lower abdomen must . hormonal assay . thyroid profile .urine r/e n c/s .
Ask when last menstrual period occurred. The presence of menstrual blood in the urine can result in a false positive hematuria .. R/o UTI Do USG
Check her weight and BMI, if not done already. Do CBC, RBS, LFT, URE, TSH, PRL and USG pelvis. Most probably hormonal issues like PCOS. Weight reduction is necessary. If PCOS is confirmed advise metformin + myoinositol. Withdrawal bleed with progesterones if rest is normal.
13yr old obese girl with DUB First r/o hypothyroidism so adv TFT Secondaly assess harmonal status FSH LH AND PROLACTIN Next suggest for usg pelvis to see any pathology in uterus or adenxia R/o POCD Cbc urine and bsl You said she bleeds when urinates adv gynaecological examination and opinion
When was menarche?. Pelvic ultrasound to see uterus and adnexa. Hormonal evaluation- LH, FSH, Prolactin, thyroid profile. Review . Weight reduction by dietary and exercise advice
? AUB .. ? ANOVULATION .. NEED'S.. HORMONAL STUDY.. USG..STUDY.. GYNECOLOGICAL EXAMINATION..
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CAUSES OF SECONDARY AMENORRHEA. DISORDERS ASSOCIATED WITH LOW OR NORMAL FSH : 66 % of cases . 1. Weight loss /Anorexia. 2. Chronic Anovulation including PCOS 3. Hypothyroidism. 4. Cushing syndrome. 5. Pituitary tumor , empty sella syndrome. Sheehan syndrome. DISORDERS ASSOCIATED WITH HIGH FSH. 12 % of cases. 1. 46,XX spontaneous POF. 2. POF due to abnormal karyotype ( 45,X mosaic / ring chromosome ). 3. Pure gonadal dysgenesis. 4. Hyperprolactinaemia. 5. Asherman syndrome. DISORDERS ASSOCIATED WITH HYPERANDROGE- NISM : 1. PCOS. 2. Ovarian tumor. 3. Non classical CAH. IATROGENIC. 1. Anti psychotics. 2. Cancer chemotherapy. 3. Anti depressants. 4. Anti hypertensive.
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