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A Surprising Case Of Primary Amenorrhea - Page #1
 

Author: Elana Bannerman, MD
Co Author #1: John Stevenson, MD
Co Author #2: Pierre Rouzier, MD
Co Author #3: Greg Little, MD

Patient Presentation:
An 18-year-old female track & field athlete at a division 1 university presented to the student health clinic for her pre-participation physical.

History:
An 18-year-old female track & field athlete at a division 1 university presented to the student health clinic for her pre-participation physical. On reviewing her medical form, it was noted that she had not had a menstrual period in the past 12 months. On further questioning, she revealed that she had never had a menstrual period. She had no significant medical problems. She reported eating a balanced diet without any dietary restrictions. She did not train more than her team. In fact, she lifted less because she did not want to become too bulky. She had never been sexually active. No history of thyroid disease. She had never spoken with a physician about her amenorrhea. She did report that she did not get along well with her parents and had been under a considerable amount of stress from this. . When asked pointedly why she had never menstruated, she revealed that she was transgender.

Physical Exam:
Vitals: BP 116/76 HR 74 Height 70in. Weight 141lbs.
(BMI 20)
General: Anxious
HEENT: Coarse, shaven facial stubble
Neck: Laryngeal prominence present
CV: NRRR, no murmurs, gallops, rubs
Lungs: CTAB
Abdomen: Soft, non-tender, non-distended
Extremities: no edema.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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