Question

Write the management of a 17-year-old girl presenting with primary amenorrhoea.

Hint:

Addressing the underlying cause of primary amenorrhoea is essential, and multidisciplinary management, including medical and psychological support, may be required.

Answer 1

Step 1: Understanding the Case.
A 17-year-old girl presenting with primary amenorrhoea requires a thorough evaluation to identify the cause, which can range from hormonal to structural issues.

Step 2: Investigations.
1. **Physical examination:** To assess secondary sexual characteristics.
2. **Ultrasound:** To check for structural abnormalities such as Mullerian agenesis.
3. **Hormonal tests:** To evaluate levels of FSH, LH, estrogen, and prolactin.
4. **Karyotype analysis:** To check for genetic conditions like Turner syndrome.

Step 3: Management.
1. **Hormonal therapy:** If the cause is a hormonal imbalance, estrogen or progesterone therapy may be prescribed to induce menstruation.
2. **Surgical intervention:** If a structural abnormality is identified, surgical correction may be required.
3. **Psychological support:** Counseling may be necessary for the emotional and psychological impact of primary amenorrhoea.

Step 4: Conclusion.
Management of primary amenorrhoea is individualized, depending on the underlying cause. Early diagnosis and intervention are crucial to prevent complications and improve quality of life.