1. From the following descriptions, choose the source/classification which best describes the cause of oligo/amenorrhoea in a–h below. Each option may be used once, more than once or not at all.

Possible Answers

For each of the questions below, select the answer which is most appropriate. Each option can be used once, more than once or not at all.

a.) Menstruation has not started over the age of 16, with normal secondary sexual characteristics.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

b.) A 54-year-old woman with an 18-month history of secondary amenorrhoea.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

c.) A new mother 6 weeks postpartum who is breast feeding who has not started to menstruate again.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

d.) A 45-year-old woman with a >6-month history of amenorrhoea who previously had normal periods.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

e.) An 18-year-old girl, who went through menarche aged 12, has stopped having periods for the last 7 months. She is a keen athlete and goes to the gym 5 times a week and her BMI is now 18; previously it was 22.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

f.) A woman with short stature and poor development of secondary sexual characteristics for which she takes hormones. As a result she has regular withdrawal bleeds. Her karyotype is 45 X0.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

g.) A woman with secondary amenorrhoea and galactorrhoea is told that she has a benign prolactinoma.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea

h.) A 40-year-old woman has no periods following overvigorous curettage of retained placental tissue leading to endometrial damage.

Choose from one of the following answersA Asherman's syndromeB Cervical stenosisC Delayed pubertyD OligomenorrhoeaE Outflow tract obstruction – acquiredF Outflow tract obstruction – congenitalG Pathological cause – hypothalamicH Pathological cause – ovarianI Pathological cause – pituitaryJ Physiological amenorrhoeaK Primary amenorrhoeaL Secondary amenorrhoea