OB/GYN EORE Menstruation (Internal Medicine) | 20+ Questions | Amenorrhea, Dysmenorrhea, PMS, PMDD, Menopause | 2025/2026

This document presents 20+ concise, high-yield, exam-verified Q&A cards on menstrual cycle disorders for the OB/GYN End-of-Rotation Exam (EORE), structured for the 2025/2026 academic year. It systematically covers the pathophysiology, diagnosis, and management of key conditions involving the menstrual cycle, with clear diagnostic workups and treatment strategies ideal for clinical reasoning and exam prep. Covered topics include: Amenorrhea: Primary amenorrhea (e.g., Turner's syndrome, androgen insensitivity, Mullerian agenesis, imperforate hymen) Secondary amenorrhea (e.g., pregnancy, PCOS, prolactinoma, hypothyroidism, Asherman syndrome) Workup includes β-hCG, TSH, prolactin, followed by FSH, LH, and progesterone challenge to assess estrogen levels. Dysmenorrhea: Primary (no identifiable pathology, linked to excess prostaglandins and uterine contractions), treated with NSAIDs and OCPs Secondary (due to fibroids, PID, endometriosis, adenomyosis, or IUD), requiring identification and treatment of the underlying cause. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD): Defined by mood, appetite, and physical symptoms during the luteal phase with a symptom-free follicular phase. Diagnostic evaluation includes CBC and TSH; management options include SSRIs, pyridoxine (Vitamin B6), NSAIDs, and OCPs. Menopause: Defined as 12 consecutive months without menstruation, average onset ~51.5 years. Diagnosis confirmed by FSH >30 mIU/mL. Discusses vasomotor symptoms, osteoporosis risk, hormone replacement therapy (HRT), and alternatives such as black cohosh and soy. Dysfunctional Uterine Bleeding (DUB): Commonly due to PCOS, obesity, or adrenal hyperplasia, with presentations like menorrhagia, polymenorrhea, metrorrhagia. A diagnosis of exclusion, confirmed with normal labs (β-hCG, FSH, prolactin, CBC). Treated with OCPs, D&C, ablation, or hysterectomy depending on severity. This document is best suited for: PA and medical students preparing for the OB/GYN EORE NP and nursing students learning menstrual and reproductive endocrinology USMLE Step 2, COMLEX Level 2, and PANCE candidates reviewing menstrual disorders and endocrine dysfunction Students in clinical OB/GYN rotations needing fast, effective revision material Keywords: primary amenorrhea, secondary amenorrhea, Turner's syndrome, androgen insensitivity, Mullerian agenesis, progesterone challenge, dysmenorrhea, endometriosis, PMS, PMDD, menopause, FSH, HRT, hot flashes, DUB, PCOS, metrorrhagia, menorrhagia, anovulatory cycles, OCPs, uterine bleeding