Chapter 6 - Reproductive System Concerns

Question 1

Normal Menstrual Patterns

Answer 1

Menses every 28 days
Range from 26-34 days
When menses first starts takes15 months for first 10 cycles then 20 cycles to become regular

Question 2

Amenorrhea

Answer 2

Absence of menstrual flow
By age 14 years if no secondary sexual characteristics should be evaluated
By age 16 years no menses even with secondary characteristics
(most girls have had injury to open hymen, if not then have to go to surgery)

Question 3

Exercise associated amenorrhea-

Answer 3

low body weight/fat greatest risk-low bone density

Question 4

Hypogonadotropic amenorrhea

Answer 4

Problem in central hypothalamic-pituitary axis
Results from hypothalamic suppression
Assessment
Counseling and education
Stress can affect

Question 5

Dysmenorrhea

Answer 5

Pain during or shortly before menstruation

Question 6

Primary dysmenorrhea

Answer 6

Abnormally increased uterine activity
Physiologic alteration
Alleviating discomfort
(too much bleeding)

Question 7

Secondary dysmenorrhea

Answer 7

Acquired menstrual pain
Diagnosis and treatment
(bad cramps)

Question 8

Dysmenorrhea Tx

Answer 8

NSAID start 2-3 days before
BCP
Heat
Exercise
Decreased salt and refined sugar intake
Increased water
Decrease red meat

Question 9

Meds for Dysmenorrhea

Answer 9

BCP prevent ovulation

Decrease amount of mentrual flow

Question 10

Premenstrual syndrome (PMS)

Answer 10

Cyclic symptoms occurring in luteal phase of menstrual cycle

PMS: cluster of physical, psychologic, and behavioral symptoms-30-80% of women experience

Question 11

Premenstrual dysphoric disorder (PDD)

Answer 11

Severe variant of PMS
Feel overwhelmed
(affects daily life)

Question 12

PMS

Answer 12

Fluid retention
Behavior or emotional changes
Irritability
Panic attacks
Impaired ability to concentrate
Cravings: sweets, salt, increased appetitie, binges
Headaches, fatigue,backache

Question 13

Endometriosis def

Answer 13

Presence and growth of endometrial tissue outside of the uterus
6-10% of women

Question 14

Endometriosis Major Symptoms

Answer 14

Dysmenorrhea

Deep pelvic dyspareunia (painful intercourse)

Question 15

Endometriosis Management

Answer 15

Drug therapy

Surgical intervention

Question 16

Endometriosis

Answer 16

Impaired fertility due to adhesions
Treatment: No pain and don’t want to become pregnant do not require tx
NSAID
BCP
Surgery

Question 17

Alterations in cyclic bleeding

Answer 17

Oligomenorrhea-40-45 day cycles
Hypomenorrhea-scanty bleeding
Metrorrhagia-intermittent bleeding
Menorrhagia (hypermenorrhea)-excessive bleeding
Dysfunctional uterine bleeding

Question 18

Oligomenorrhea-

Answer 18

40-45 day cycles

Question 19

Hypomenorrhea-

Answer 19

scanty bleeding

Question 20

Metrorrhagia-

Answer 20

intermittent bleeding

Question 21

Menorrhagia (hypermenorrhea)-

Answer 21

excessive bleeding

Question 22

Dysfunctional uterine bleeding (DUB)

Answer 22

Excessive uterine bleeding, no identified cause

Can have decreased H and H

Question 23

Menopause

Answer 23

Late 40’s
Median age US 51-52
Perimenopause-tranisiton from normal cycle
Complete cessation of menses
Physiologic characteristics - Anovulation occurs more frequently, Menstrual cycles increase in length, Ovulation occurs with less frequency

Question 24

Physical changes during the perimenopausal period

Answer 24

Bleeding
Genital changes
Vasomotor instability-75% of women
Hot flush-look red
Hot flash-feel hot
Night sweats

Question 25

Mood and behavioral responses of Menopause-

Answer 25

persons perception of menopause

Question 26

Health risks of perimenopausal women

Answer 26

(increase)
Osteoporosis
Coronary heart disease

Question 27

Menopausal hormonal therapy

Answer 27

Decision to use hormone therapy
Side effects
Treatment guidelines
Alternative therapies

Question 28

Osteoporosis

Answer 28

Decreased bone density
Estrogen stimulates osteoblast (help form bone)
Estrogen needed to convert Vit D into calcitonin which is needed to absorb calcium form the gut
50% of US women have some form of osteoporosis
(risk factors: caucasian, obese, certain meds)
(tell young girls to drink milk)

Question 29

Coronary Heart Disease

Answer 29

Risk of developing or dying from heart disease after menopause is increased
Obesity, smoking, increased cholesterol, BP, diabetes, alcohol abuse

Question 30

Hormone Replacement Therapy HRT

Answer 30

Until 2002 HRT was widely used
**Study called the Women’s Health Initiative from the National Institutes of Health showed increased clots, heart attack, stroke, breast cancer
Take lowest possible dose for shortest period of time

Question 31

Key Points

Answer 31

Menstrual disorders diminish quality of life for affected women and their families

Question 32

Key Points

Answer 32

PMS is a disorder that begins in the luteal phase of the menstrual cycle and ends with the onset of menses
Not a purely psychologic problem

Question 33

Key Points

Answer 33

Endometriosis is characterized by secondary amenorrhea, dyspareunia, abnormal uterine bleeding, and infertility

Question 34

Key Points

Answer 34

The perimenopause is a normal developmental phase progressing from the reproductive to the nonreproductive stage

Question 35

Key Points

Answer 35

During perimenopause, women seek care for bleeding irregularities, vasomotor instability, fatigue, genital changes, and changes related to sexuality

Question 36

Key Points

Answer 36

Alternative therapies are beneficial in relieving discomforts associated with menstrual disorders and menopause

Question 37

Key Points

Answer 37

Osteoporosis: progressive loss of bone mass from decreasing levels of estrogen after menopause
Can be prevented or minimized with lifestyle changes and medication

Question 38

Key Points

Answer 38

Estrogen increases calcitonin levels to prevent bone resorption and maintain bone density

Question 39

Key Points

Answer 39

Postmenopausal women at increased risk for coronary artery disease because of changes in lipid metabolism
Sexuality continues after menopause