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
Endometriosis is what?
Bits of functioning endometrial tissue are located outside of their normal site, the uterine cavity
Need: surgery, medication
Assess for: infertility and pain, pelvic tenderness, tender nodular masses on uterosacral ligaments, posterior uterus, or posterior cul-de-sac
Infertility Primary is what?
unable to conceive after 1 year of unprotected intercourse
Infertility Secondary is what?
inability to conceive after a previous pregnancy
Male Fertility Assessment
semen analysis, sexual characteristics, external and internal reproductive organ exam, digital prostate exam
Female Fertility Assessment
ovarian function, pelvic organs
Fertility Assessment Lab & Diagnostics:
home ovulation kits, clomiphene citrate (Clomid) challenge test, hysterosalpingogram, laproscopy
Contraceptive : Behavioral Methods
- abstinence
- fertility awareness: cervical mucus ovulation, basal body temp, standard days method, symptothermal method
- withdrawal (coitus interruptus)
- lactational amenorrhea
Contraception : Barrier Methods
- condoms - male/female
- diaphragm w/ spermicide
- cervical cap w/ spermicide
- contraceptive sponge w/ spermicide
Contraception : Hormonal Methods
- oral contraceptives
- injectable contraceptives
- transdermal patches
- vaginal rings
- implantable contraceptives
- intrauterine contraceptives
- emergency contraception
Contraception : Sterilization
Women:
Tubal Ligation - fallopian tubes are grasped and sealed
MEN:
Vasectomy - local anesthesia & involves cutting the vas deferens which carries the sperm
Abortion surgical:
vaccum extraction
D&E - dilation & evacuation
Abortion medical:
methotrexate followed by misoprostol
mifepristone followed by misoprostol
Impact of Menopause on the Body
Brain: hot flashes, sleep, mood, memory problems
Heart: lower levels of HDL; risk of CVD
Bones: bone density loss; risk of osteoporosis
Breasts: duct/gland tissue replaced by fat
GU: vaginal dryness, stress incontinence, cystitis
GI: less Ca+ absorbed, fractures
Skin: dry, thin, collagen decreases
Body shape: increase abdominal fat, waist swells to size of hips
