3.2 Menstrual Dysfunction

Question 1

How much blood is normally lost in a normal menstrual cycle?

Answer 1

37-43ml/cycle

Question 2

What is menorrhagia?

Answer 2

Lose >80 ml blood per cycle

Often results in anaemia

Question 3

Give 3 causes of menorrhagia

Answer 3

Fibroids
Cancer
Progesterone contraception 
IUCD
Dysfunctional uterine bleeding- no known cause

Question 4

What is primary amenorrhoea?

Answer 4

Never had a period at >16 years old

Question 5

What is secondary amenorrhoea?

Answer 5

Have periods but then they stop for >3 months

Question 6

Give 3 causes of physiological amenorrhoea

Answer 6

Pregnancy
Menopause
Pre-puberty

Question 7

Give 3 causes of amenorrhoea related to the outflow tract

Answer 7

Vaginal atresia
Imperforate hymen
Intrauterine adhesions

Question 8

Give 3 causes of amenorrhoea related to the HPG axis

Answer 8

Turner’s syndrome
Polycystic ovary syndrome
Androgen insensitivity

Question 9

What is Kallmann’s syndrome?

Answer 9

Chromosomal defect in hypothalamus development

Question 10

What is Sheehan’s syndrome?

Answer 10

Pituitary necrosis after blood loss in child birth

Question 11

What is dysmenorrhoea?

Answer 11

Painful menstruation

Question 12

What is oligomenorrhoea?

Answer 12

Irregular periods more than 35 days apart

Question 13

What is PMS?

Answer 13

Emotional or physical symptoms occurring 5-11 days before menses. Includes bloating, headaches, fatigue, mood swings and forgetfulness

Question 14

What is hyperprolactinaemia?

Answer 14

Excessive prolactin secretion from the anterior pituitary causing secondary amenorrhoea and inappropriate breast milk production

Question 15

What is polycystic ovary syndrome?

Answer 15

Characterised by secondary amenorrhoea and physical signs of hyperandrogenism.
Follicles are stimulated to develop but no dominant follicle is selected. Ratio of LH to FSH is increased due to increased LH secretion and inhibited FSH secretion