Withdrawal bleeding following administration of progestogen in a case of secondary amenorrhoea indicates all except :
Correct Answer: Defect in pituitary gonadal axis
Description: Positive Progesterone Challenge Test :This test depends on the presence of oestrogen-primed endometrium in the uterine cavity. The test is considered positive if the patient responds to the administration of oral tablet medroxyprogesterone (Provera/Modus/Deviry) 10 mg daily for 5 days or injection progesterone in oil 100 mg intramuscularly or primolut-N 5 mg three times a day for 3 days. Withdrawal bleeding occurs within 2-7 days. A positive test indicates amenorrhoea secondary to anovulation. The common underlying causes are hypothalamic dysfunction and polycystic ovary syndrome. Negative test requires giving oestradiol 0.02 mg or conjugated oestrogen 1.25 mg for 25 days and progestogen from 16th to 25th day. Negative test suggests endometrial unresponsiveness in the presence of normal FSH. Reference : Shaw's Textbook of Gnaecology 16th edition page no 330
Category:
Gynaecology & Obstetrics
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