Gynecology Case 1

History

Paula Johnston is a 26 year old accountancy student who comes to you complaining of absence of menstruation for a period of 4 months.

---

What is the presenting complaint?

Presenting Complaint

Oligomenorrhoea - this is the absence of menstruation for a period between 6 weeks and 6 months. Amenorrhoea is the absence of periods for over six months

The etiology of oligomenorrhoea is extensive. You make it easier for yourself by narrowing it down to specific organ systems. Dysfunction of which organ systems and organs can cause oligomenorrhoea?

Etiology

Endocrine System

• Hypothalamus
• Pituitary Gland
• Thyroid Gland
• Pancreas
• Adrenal Gland

Reproductive/Endocrine System

• Ovaries

Verbally practice your history taking from a patient with oligomenorrhoea. What information will you try to attain from the patient?

Full History and Responses

History of Presenting Complaint

• Onset: 4 months ago
• Periodicity: Constantly no periods
• Duration: 4 months
• Has this happened before? No

Menstrual History (normal)

• Menarche: 12 years old
• 1st day of last menstrual period: 4 months ago
• No. of days bleeding: 3
• Frequency: 26-30 days
• Regularity: Irregular
• Bleeding between periods: No
• Bleeding after intercourse: No
• Nature of periods - clots? No
• Heavy? Light
• Flooding? No

Past Gynecological History

• Gynecological symptoms: None
• Gynecological diagnoses: None
• Gynecological surgery: None
• Abnormal smears: None

Past Obstetric History

• No. of children: None
• No. of pregnancies: None

Drug History

• Prescribed Medications: None
• Non-prescribed medications: None
• Recreational drugs: None

Family History

• Medical Conditions: None
• Gynecological conditions: Premature Menopause (Mother at 37; Sister at 35)
• Malignancies: None

Social History

• Support Network: Extensive
• Smoking: No
• Alcohol: No