amenorrhea

Abnormal uterine bleeding is a common gynecologic complaint. Review the following scenarios and determine a likely cause and describe the mechanism that leads to the abnormal bleeding pattern.

A 21-year-old woman is having episodes of amenorrhea and infrequent menses. Her menarche was at the age of 14 and her menses have sometimes been regular. She is overweight and says despite her efforts to lose weight, she does not do so. She is generally very healthy otherwise and the only medication she is taking is doxycycline for acne, which she feels is getting worse. She said her mother’s menstrual pattern was the same and that her mother told her she had trouble getting pregnant (the patient is an only child). She is sexually active, her partner uses condoms consistently, and her urine pregnancy is negative.