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