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Amenorhea (Primary (No Breast (Turners Syndrome (Streak Gondas (LOW…

- - - - 45XO Genotype
      - Feature Turners : Short +webbed Neck + inftanle Gondaism
      - Streak Gondas
        
        LOW esgrogen = No breast
      - High FSH
    - - LOW FSH
        
        LOW FSH LOW Estrogen = no breast
      - Kallimans Syndrome
        
        Ansomia
        
        HypoGondaoTropic HypoGondaism
      - Pitutary Tumor
      - Stress
  - - - XX Genotype
      - UltraSound
      - Recounstrictive Vagina
      - infertility
    - - XY Genotype
      - Ultrasound
      - Normal Looking Female
      - Testicles is Present and Must be Removed
  - - - Vaginal Agensis
      - Imperfated Hymen
- - - - Thyroid Function
        
        Normal
        
        abnormal ( thyroid Dysfunction )
        
        HIGH TSH inhibts FSH
      - Prolactin
        
        Normal
        
        Abnormal
        
        HyperProlactinmia
        
        Drugs
        
        Tumors
      - Hiristusm?
        
        No
        
        Hypothamic Pitutary Dysfunction
        
        Stress + Excersice
        
        Yes
        
        HyperAndroginsm
        
        PCOS
        
        FSH and LH
        
        UltraSound ( Mutlipel Cysts )
        
        HyperAndroginsm ( Testerone + SBG )
        
        Cushing Disease
        
        Free Cotizol
        
        Oviran or Adrenal Tumor
      - Means Anovluation
      - Estrogen is Ok and Present but no Progestrone due to Anovulation ( No Corpus Letum Source of Progestrone )
    - - Estrogen Progestroine Chalange
        
        Negtive
        
        Obsturction
        
        Asherman Syndrome
        
        Postive
        
        No Estrogen
        
        FSH and Lh ( Test )
        
        Low ( Hypothamic Dysfunction )
        
        No Estrogen due to LOW FSH and Lh
        
        Thrombosis ( Sheehans )
        
        Tumor
        
        Stress
        
        High ( Oviran Failrue )
        
        No Estrogen due No Follicules
      - Maybe Due to Lack or 1) Estrogen or 2) Anatomical