Reproductive and endocrine disease Shujun Gao. Individual Each in normal position Each keeps normal...
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![Page 1: Reproductive and endocrine disease Shujun Gao. Individual Each in normal position Each keeps normal activity Each has normal reaction.](https://reader031.fdocuments.in/reader031/viewer/2022020417/56649ebf5503460f94bc9ae0/html5/thumbnails/1.jpg)
Reproductive and endocrine disease
Shujun Gao
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Individual
• Each in normal position
• Each keeps normal activity
• Each has normal reaction
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System
• Normal——interaction in balance
• Dysfunction——lost of balance
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Inferior colliculus
GnRH
Pituitary gland
Gonadotropin
FSH LH
progestogenestrogen
Center stratum cutaneum
??
Reproductive endocrine
axis
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amenorrhea
• xxx , 16-year-old with secondary sexual characters ,but absence of menstruation
• Question : What is the diagnosis and how to treat?
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Correlated knowledge
• The initiate and maintain of the normal menstruation
• Normal growth sequence of puberty
• Conditions of ovarian growth
• Physiologic function of ovarian
• Methods of examination of ovarian function
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Causation and pathophysiology
• Hypothalamic amenorrhea
• Pituitary amenorrhea
• Ovarian amenorrhea
• Uterine amenorrhea
• Congenital dysplasia of low genital tract
• Dysfunction of other endocrine glands
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Definition
• It is a common symptom ,not a disease
• Primary amenorrhea : secondary sexual characters
not appears after 14-years or no menarche after 16-y
ears although secondary sexual characters appeared.
• Secondary amenorrhea : cessation of the periods for
6months after menstruation has been established
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Classification (one)
• Primary amenorrhea——most due to congenital diseases or functional disorder and deformed genital tract,about 5% 。
• Secondary amenorrhea——most due to secondary dysfunction or tumor,about 95% 。
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Classification (two)
•Physiologic amenorrhea
•Pathological amenorrhea
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Classification ( three )
According to the anatomic site
• Congenital dysplasia of low genital tract
• Uterine amenorrhea
• Ovarian amenorrhea
• Pituitary amenorrhea
• Central nerve-hypothalamic amenorrhe
a
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Classification ( four ) According to the level of sex hormone
• Hypergonadotropic hypogonadism :
FSH≥30IU/L , lesion presence in ovar
ian
• hypogonadotropic hypogonadism :
FSH and LH both<5IU/L , lesion pres
ence in center
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Dysfunctional uterine bleeding
• Patient ——Troubled by dysfunctional uterine bleeding sees a doctor to resolve bleeding and to get normal menstruation
• Doctor —— you , should know how to satisfy the patient
• To solve the problem, diagnosis, differential diagnosis and treatment should be mastered
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• Patient : 17-year-old , 46kg• Chief complaint : menstrual disorder for 2 months,vaginal bleeding for 18
days• Menstruation: 11year 5-7/20-30days 。 Pmp 2007.07.03 ,Lmp 2007 08.24 。• History of present illness: She had a heavy vaginal bleeding from September
5th, 2007 ,accompany with dizziness, vertigo and fatigue,and was hospitalized emergency
• Medical examination: T36.7 、 P88cpm 、 R21cpm 、 BP90/50mmg. depressed with an anemia face• Gynecology examination : corpus : middle position with normal size adnexa : no masses• ultrasound: UT46× 45×40mm, EN10mm ROV31×28×23mm, LOV33×17×16mm. Cul-de-sac hydrops : 18mm.
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discussion
• diagnosis : puberty dysfunctional uterine bleeding secondary anemia• Procedure of diagnosis: history of illness medical examination gynecological examination auxiliary examination : urine HCG 、 ultrasound 、 sex hormone 、 blood routine.• Therapeutics : sex hormone diagnostic curettage antibiotics treatment of anemia