Menstrual and menopausal topics for General Physicians
How menstrual, hormonal & menopausal disorders is tested
Written for DHA, SMLE, DOH, QCHP, OMSB, MOH, NHRA and Kuwait MOH — the same GP licensing mix, not a menstrual, hormonal & menopausal disorders specialist paper.
These stems are PALM-COEIN bleeding, Rotterdam PCOS, primary vs secondary amenorrhoea, and HRT that is not a reflex prescription.
Heavy bleeding is structurally vs hormonally sorted. PCOS is two of three Rotterdam features, then metabolic screening. Amenorrhoea workup starts with hCG, TSH, prolactin, then FSH.
Menopause items are vasomotor treatment and when HRT is wrong (breast cancer, unexplained bleeding, VTE). Osteoporosis screening appears beside it.
First test in secondary amenorrhoea?
Pregnancy test. Then TSH and prolactin. Do not start with a hysteroscopy.
PCOS — must she have cysts on scan?
No. Rotterdam is two of oligo-ovulation, hyperandrogenism, and PCO morphology. Metabolic workup still matters in Gulf clinics.
HRT contraindication they love?
Current breast cancer, unexplained PV bleeding, or prior VTE depending on the route. Age alone is not an automatic no.
More Gynae subspecialties