Monday, August 17, 2009

No Easy Way To Say This

A 35 year old G0P0 with autoimmune adrenal and thyroid disease presents with pain with sexual intercourse. She has vaginal dryness, decreased libido, poor sleep, and night sweats. She was previously on oral contraceptives for 10 years but stopped about 2 years ago. Since then, her periods have not been regular. Karyotype is normal. FSH is elevated. Pregnancy test is negative.

Challenge: What's your diagnosis?

3 comments:

shabnam said...

Premature Ovarian failure...And there really is'nt an easy way to say this

Stephanie said...

premature ovarian failure

Craig Chen said...

yep
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No Easy Way To Say This

This is premature ovarian failure or premature menopause which is depletion of oocytes before age 40. Symptoms of estrogen deficiency include hot flashes, vaginal dryness, poor sleep, decreased libido. Loss of negative feedback of estradiol and inhibins results in high FSH. Most often, the disease is idiopathic, but may also be due to autoimmune destruction, karyotypic abnormalities, or fragile X premutation.

Source: UpToDate.