A. Amenorrhea and Dysfunctional Uterine Bleeding

The student will be able to:

1. Describe the normal functions and interactions of the endocrine components of the hypothalamic-pituitary-ovarian axis, which brings about the normal menstrual cycle.

2. Define primary and secondary amenorrhea and a list of differential diagnoses for each.

3. Divide the causes for amenorrhea according to the site at which the abnormality is occurring; at the level of the hypothalamus, the pituitary, the ovary, and the endometrium.

4. Outline the principles of investigation and management of these abnormalities, according to the patient's desire for pregnancy.

5. Outline the principles of investigation and management for;

- ovulatory dysfunctional uterine bleeding

- anovulatory dysfunctional uterine bleeding.

B. Normal Pubertal Development and its Abnormalities

The student will be able to:

1. Outline normal pubertal development, stating the normal age ranges and sequences for thelarche, pubarche and menarche.

2. Describe Tanner staging of puberty.

3. Define precocious puberty, differentiating central causes from other causes.

4. Describe the etiology of precocious puberty.

5. Outline the principles of investigation and management of precocious puberty.

6. Define delayed puberty.

7. Describe the etiology of delayed puberty (with gonadal failure and without gonadal failure).

8. Outline the principles of investigation and management of delayed puberty.

C. Hirsutism and Virulization

The student will be able to:

1. Describe normal variations in hair distribution and recognize abnormal patterns.

2. Define hirsutism and virulization.

3. List the causes of elevated circulating androgen levels.

4. Outline the principles of investigation and management of hirsutism and virulism.

D. Hyperprolactinemia

The student will be able to:

1. List the causes of hyperprolactinema (physiological, pharmacological and pathological).

2. Outline the appropriate investigation for pathological hyperprolactinema.

3. Describe the treatment for hyperprolactinema.

E. Premature Gonadal Failure

The student will be able to:

1. Describe the etiology of premature ovarian failure.

2. Describe the signs, symptoms and laboratory diagnosis of ovarian failure.

3. Outline the treatment for premature ovarian failure, including the risk and benefits of hormone replacement therapy and the issue of infertility.