(3.1&2) Menstural Dysfunction, Puberty & Menopause Flashcards
Dysmenorrhoea = ?
Painful period = ?
Amenorrhoea = ?
Absence of period >6 months = ?
Oligomenorrhoea = ?
Infrequent period (35 days - 6 months) = ?
Cryptomenorrhoea = ?
Invisible period due to outflow obstruction = ?
Menorrhgia = ?
Excessive (>80ml/day) or prolonged (>7days) period = ?
How do you treat Menorrhgia?
- Progesterone -> maintain Corpus Luteum
- NSAIDs
What is Ovulatory Cycle?
Normal period + Dysmenorrhoea or Mastalgia (sore breasts)
What is Anovulatory Cycle?
No Ovulation/Luteal phase + Oligomenorrhoea/Amenorrhoea +/- Menorrhgia
What is Primary Amenorrhoea?
Never had a period:
- Girls >14 years old if without secondary sexual characteristics
- Girls >16 years old if with secondary sexual characteristics
Suggest some hypogonadotrophic and some hypergonadotrophic causes of PRIMARY Amenorrhoea.
- Hypogonadotrophic: Kallmann Syndrome (hypothalamic, inadequate GnRH to stimulate FSH production)
- Hypergonadotrophic: Androgen insensitivity, Receptor abnormalities, Turner Syndrome
What is Secondary Amenorrhoea?
Ceased period:
- > 3 months if regular period before
- > 9 months if irregular period before
Suggest some hypogonadotrophic and some hypergonadotrophic causes of SEONDARY Amenorrhoea.
- Hypogonadotrophic: stress, exercise, eating disorder, Hyperprolactinaemia, Hypo/Hyperthyroidism
- Hypergonadotrophic: Menopause, Polycystic ovary, drugs
Which age groups are Secondary Amenorrhoea most likely to be seen?
Women 40-55 years old
What is Dysfunctional Uterine Bleeding?
Abnormal bleeding without obvious organic causes
What may the possible causes of Dysfunctional Uterine Bleeding?
- 90% No ovulation -> no Corpus Luteum to release Progesterone -> continuous Oestrogen production -> Uterine overgrowths & bleeds
- 10% Ovulation -> reduced Oestrogen -> continuous Progesterone secretion -> Uterine sheds irregularly
At what age does male’s puberty normally take place? In what sequence do males produce their secondary sexual characteristics?
- 9-14 years old
- Genitalia development
- Adrenarche
- Spermatogenesis
- Growth spurt
- Genitalia adult
- Pubic hair adult
At what age does female’s puberty normally take place? In what sequence do females produce their secondary sexual characteristics?
- 8-13 years old
- Thelarche
- Adrenarche
- Growth spurt
- Menarche
- Pubic hair adult
- Breast adult
What initiates Puberty? What factors may influence its onset?
- Large increase in GnRH production
- Environmental factors e.g. Body weight
What is the crucial body weight to initiate growth spurts in male and female?
- Male: 55kg
- Female: 30kg
What is the critical body weight to initiate Menarche in females?
47 kg
How does Growth Spurt ends? Why does and individual with earlier onset ends up shorter?
- Fusion of Epiphyseal plates
- Constant slower growth before the spurt, earlier starting point, earlier ending point compared to those who start later and grow slower but more before the spurt
What do you call it if a child starts his puberty too early? What may be the possible causes?
- Precocious Puberty
- True: early production of GnRH e.g. Meningitidis/Pineal Tumours
- Pseudoprecocious Puberty: uncontrolled Gonadotrophins/Steroids e.g. Hormone Secreting Tumours/Steroid drugs/Adrenal hyperplasia
What are the differences between menopause in males and females?
- Males later and slower
- Males continuous spermatogenesis
- Females run out of follicles
Suggest 8 effects of reduced level of Oestrogen in females after menopause.
- Vascular: hot flushes
- Uterine: Endometrium regresses; Myometrium thins
- Vagina: reduced Rugae hence distension
- Breast atrophy
- Osteoporosis/Posture and height changes/Risk of fracture
- Changes in lipid/cholesterol -> CHD
- Emotional distress/poor sleep
- Vaginal/Urethral atrophy -> Dyspareunia/Dysuria
