CH 4 Flashcards
Common Menstrual Disorders
- Amenorrhea
- Dysmenorrhea
- dysfunctional uterine bleeding (DUB)
- premenstrual syndrome (PMS)
- premenstrual dysphoric disorder (PMDD)
- endometriosis
Common Women’s Reproductive Disorders
- menstrual disorders
- infertility
- contraception
- abortion
- menopause
Amenorrhea is what?
-absence of menses during reproductive years
Two types of PRIMARY amenorrhea:
- absence of menses by age 14 w/ absence of development of secondary sexual characteristics
- absence of menses by age 16 WITH normal development of secondary sexual characteristics
Therapeutic Management: correction of any underlying disorders and estrogen replacement therapy
Pituitary tumor – drug therapy, surgical resection, radiation
Secondary Amenorrhea:
the absence of regular menses for 3 cycles or irregular menses for 6 months in women who have previously menstruated regularly
Therapeutic Management: cyclic progesterone, tx of hyperprolactinemia, eating disorder, obesity, hypothalamic failure, hypotheyroidism
Oral contraceptives, bromocriptine, nutritional counseling, GnRH therapy, thyroid replacement
Dysmenorrhea is:
painful menstruation
Primary Dysmenorrhea
(spasmodic)
increased prostaglandin production (primary)
Secondary Dysmenorrhea
(congestive)
pelvic or uterine pathology
-ENDOMETRIOSIS most common cause of secondary dysmenorrhea
Dysmenorrhea Tx:
suppress hormones if endometriosis is suspected & cannot be tx w/ surgery
Administer: low dose oral contraceptives, prostaglandin inhibitors to reduce pain, Depo-Provera to suppress ovulation, lifestyle changes
Dysmenorrhea S/S:
pain, nausea, vomit, diarrhea, fatigue, fever, HA, dizziness, bloating, water retention, weight gain, muscle aches, food cravings, breast tenderness
Comfort measures: heat, lifestyle changes, pain relief
Assess: past medical hx, sexual hx, menstrual hx
AUB
(abnormal uterine bleeding) is:
-painless endometrial bleeding that’s prolonged, excessive, irregular, and not attributed to any underlying or systemic disease
-occurs most often at beginning and end of reproductive years
AUB Therapeutic Management:
normalize the bleeding, correct anemia, prevent/diagnose early cancer, restore quality of life
-meds or insertion of hormone secreting intrauterine system
-surgery: dilation & curettage (D&C), endometrial ablation, uterine artery embolization, hysterectomy
PMS & PMDD
premenstrual dysphoric disorder: more severe variant
-vit supplements, diet changes, exercise, lifestyle, meds
mood disorders are main symptoms of PMDD
Categorizing PMS s/s:
A - anxiety
C - craving
D - depression
H - hydration
O - other
assess: irritability, tension, dysphoria
PMS ACOG diagnostic criteria:
-having at least one of the following affective and somatic s/s during the 5 days before menses
Affective: depression, angry outbursts, irritability, anxiety
Somatic: breast tenderness, abdominal bloating, edema, HA
Symptoms relieved from days 4-13
