Abnormal/Irregular vaginal bleeding Flashcards
On average how much blood is lost per menstural cycle?
<80ml
What is menorrhagia?
Heavy or prolonged menstural flow
What is metorrhagia?
Regular intermenstural bleeding
What is amenorrhoea?
Absence of mensturation >6 months
What is oligomenorrhoea?
Menses at intervals of >35 days
Causes of AUB in adolescence/early reproductive life?
DUB
Pregnancy/Miscarriage
Endometriosis
Bleeding disorders
Causes of AUB post menopause?
Atrophy Endometrial polyp Exogenous hormones Endometriosis Bleeding disorder
What is the difference between organic and non-organic causes of AUB?
organic - presence of pathology
non-organic - absence of pathology (i.e. dysfunctional uterine bleeding)
What is adenomyositis?
Endometrial glands and stroma in the myometrium
Polyps are common, especially around menopause. What do you have to look out for?
They are mostly bengin
BUT endometrial carcinoma can preset as a polyp
How does the coil affect periods?
Progesterone coil= Light periods
Copper coil= Heavy periods
What colour does endometriosis present as?
Initially red due to collection of blood, then inflamamtory reaction, fibrosis and then the lesion turns black
Why is it rare to see endometritis?
Cervical mucous plug protects endometrium from ascending infection + cyclical shedding makes it relatively resistant
What is chronic plasmacytis endometritis associated with?
Pelvic inflammatory disease (PID)
Which 3 conditions may present with pain and heavy periods?
ADENOMYOSIS
PID
Endometriosis
How do prolactin disorders generally affect periods?
Tend to get amenorrhoea
What are the two subdivisions of non-organic bleeding?
Anovulatory
Ovulatory
Anovulatory non-organic bleeding. How does this present?
At extremes of reproductive life
Irregular cycle
More common in obese women
CORPUS LUTEUM DOES NOT FORM
Ovulatory non-organic bleeding. how does this present?
More common 35-45
Regular heavy periods
Due to inadequate progesterone produced by corpus luteum
TRUE/FALSE
TVUS is diagnostic for polys ect
FALSE
It is v helpful but need histology results for diagnosis
Possible management of non-organic bleeding
Progesterone-releasing IUCD (Mirena IUS) Tranexamic acid Progesterones IM COCP Surgery
Chat about Mirena
Don’t need to worry about compliance
Lasts for 5 years
Delivered locally so don’t get 1st pass effect
Reduces bleeding
SE- Irregular bleeding for 1st 4-6 months and progesterone effects
Which group of people is transexamic acid especially helpful in?
Useful in those trying to conceive as non-hormonal
What is the most common gynaecological presentation?
Menorrhagia
Which 4 anatomical areas may be a problem if there is amenorrhoea?
Hypothalamus
Pituitary
Ovaries
uterus
What age does mensturation usually start?
Age 13
What are the two definitions of primary amenorrhoea?
- Failure to have a period before age 14 with no secondary characteritics
- Failure to have a period before age 16 with secondary characteristics
If an imperforate hymen is not treated what are two possible complications?
Peritonitis
Endometriosis
What is Post menopausal bleeding defined as?
AUB >1 year after cessation of mensturation
