Endocrine Abstracts

18 year old female was referred to endocrinology from Paediatric and adolescent gynaecology with secondary amenorrhea. She had her menarche at age of 15 years with profuse bleeding for three days only, no spontaneous periods afterwards. She had no symptoms of weight gain, increased hair growth, galactorrhea, headache or any skin changes. She had significant history of hair loss. She had normal milestones. She achieved her adrenarche and thelarche at age of 12-13 years. Family history unremarkable. She has normal weight BMI= 23, no signs of hirsutism except her Scalp hair line is thin. No Skin changes pertinent to Cushing’s syndrome, insulin resistance. Her hormonal profile revealed normal FSH, LH estradiol and progesterone. Although she has raised Testosterone 4-4.2ng/l on consecutive occasions. DHEAS, Androstenedione, 17 0H progesterone normal. Her further workup showed normal ovarian morphology. MRI adrenal unremarkable. She is labelled as case of polycystic syndrome on basis of her oligomenorrhea and increase testosterone level. She received metformin along with mini pill and then medroxyprogesterone without any effect on her cycle. She later received combined oral contraceptive pill resulting in withdrawal bleeding. This case is unusual presentation in the context of Secondary amenorrhea just after onset of menarche 1,2. No clinical features. No response to metformin and progesterone. 1-Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004 Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25 [PubMed] [Google Sr]. 2-Characterization of Functionally Typical and Atypical Types of Polycystic Ovary Syndrome JJ Clin Endocrinol Metab. 2009 May; 94(5): 1587–1594. Published online 2009 Feb 24. doi: 10.1210/jc.2008-2248 Jennifer Hirshfeld-Cytron, Randall B. Barnes, David A. Ehrmann, Anthony Caruso, Monica M. Mortensen, and Robert L. Rosenfield