amenorrhea

AMENORRHEA

Clinical Case:

A 26-year-old G2P2 woman presents because of no periods for 9 months. She delivered two full term healthy children vaginally and their ages are 5 and 3. She breastfed her youngest for 1 year, menses returned right after she stopped, and were monthly and normal until 9 months ago. She is not using any contraception, although intercourse is infrequent. She feels very fatigued, has frequent headaches and has had trouble losing weight. She has no history of abnormal Paps or STI*s. She takes no medications. She is married and works from home as a computer consultant. On exam, BP= 120/80, P= 64, Ht= 5*8*, Wt= 160 pounds. She appears tired but in no distress. Breasts show scant bilateral milky white discharge with manual stimulation. Breast exam reveals no masses, dimpling or retraction. Exam is otherwise normal, including pelvic exam. HCG is negative.

373 c 374 a 375 e 376 d 377 cBBB LH from basophilic cells 378 a 379 c 380 d BBBBBB hysteroscopy for AUB 381 b 382 b 383 384 385

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