A 35 years old lady is not having her menses for last 4 months. She has high serum FSH and LH level with low estradiol. The likely cause is :
Ans. is d i.e. Premature menopause Premature menopause is defined as secondary amenorrhoea before 40 years of age, due to ovarian failure. It is clinically defined as secondary amenorrhea for atleast 3 months with raised FSH, raised FSH / LH ratio and low E2 levels in a women under 40 years of age. in case of PCOD or Stein-t eyenthal Syndrome estrogen level is normal, LH is raised, LH/FSH ratio is raised. Panhypopituitarism leads to decreased LH and FSH levels which in turn leads to decreased estrogen. Exogenous oestrogen reduces FSH and LH by its feedback mechanism. Conditions Premature menopause Pan hypopituitarism Exogenous estrogen PCOD Both increased Decreased Both decreased Decreased Both decreased Increased LH increased, FSH normal Increased Also know * Categories of Amenorrhea based on Gonadotropin and Estrogen and Levels Type of Hypogonadism LH / FSH Estrogen Primary Defect Hypergonadotropic High Low Ovary Hypogonadotropic Low High Hypothalamus / pituitary Eugonadotropic Normal Normal Varied Remember : For diagnosis of premature ovarian failure serum FSH levels should be> 40 mIU / ml on 2 occasions atleast 1 month apa.
Panhypopituitarism
Polycystic ovarian disease
Exogenous estrogen administration
Premature menopause