Chapter 6 - Reproductive System Concerns Flashcards
Normal Menstrual Patterns
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
Amenorrhea
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)
Exercise associated amenorrhea-
low body weight/fat greatest risk-low bone density
Hypogonadotropic amenorrhea
Problem in central hypothalamic-pituitary axis Results from hypothalamic suppression Assessment Counseling and education Stress can affect
Dysmenorrhea
Pain during or shortly before menstruation
Primary dysmenorrhea
Abnormally increased uterine activity
Physiologic alteration
Alleviating discomfort
(too much bleeding)
Secondary dysmenorrhea
Acquired menstrual pain
Diagnosis and treatment
(bad cramps)
Dysmenorrhea Tx
NSAID start 2-3 days before BCP Heat Exercise Decreased salt and refined sugar intake Increased water Decrease red meat
Meds for Dysmenorrhea
BCP prevent ovulation
Decrease amount of mentrual flow
Premenstrual syndrome (PMS)
Cyclic symptoms occurring in luteal phase of menstrual cycle
PMS: cluster of physical, psychologic, and behavioral symptoms-30-80% of women experience
Premenstrual dysphoric disorder (PDD)
Severe variant of PMS
Feel overwhelmed
(affects daily life)
PMS
Fluid retention Behavior or emotional changes Irritability Panic attacks Impaired ability to concentrate Cravings: sweets, salt, increased appetitie, binges Headaches, fatigue,backache
Endometriosis def
Presence and growth of endometrial tissue outside of the uterus
6-10% of women
Endometriosis Major Symptoms
Dysmenorrhea
Deep pelvic dyspareunia (painful intercourse)
Endometriosis Management
Drug therapy
Surgical intervention
Endometriosis
Impaired fertility due to adhesions Treatment: No pain and don’t want to become pregnant do not require tx NSAID BCP Surgery
Alterations in cyclic bleeding
Oligomenorrhea-40-45 day cycles Hypomenorrhea-scanty bleeding Metrorrhagia-intermittent bleeding Menorrhagia (hypermenorrhea)-excessive bleeding Dysfunctional uterine bleeding
Oligomenorrhea-
40-45 day cycles
Hypomenorrhea-
scanty bleeding
Metrorrhagia-
intermittent bleeding
Menorrhagia (hypermenorrhea)-
excessive bleeding
Dysfunctional uterine bleeding (DUB)
Excessive uterine bleeding, no identified cause
Can have decreased H and H
Menopause
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
Physical changes during the perimenopausal period
Bleeding Genital changes Vasomotor instability-75% of women Hot flush-look red Hot flash-feel hot Night sweats
Mood and behavioral responses of Menopause-
persons perception of menopause
Health risks of perimenopausal women
(increase)
Osteoporosis
Coronary heart disease
Menopausal hormonal therapy
Decision to use hormone therapy
Side effects
Treatment guidelines
Alternative therapies
Osteoporosis
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)
Coronary Heart Disease
Risk of developing or dying from heart disease after menopause is increased
Obesity, smoking, increased cholesterol, BP, diabetes, alcohol abuse
Hormone Replacement Therapy HRT
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
Key Points
Menstrual disorders diminish quality of life for affected women and their families
Key Points
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
Key Points
Endometriosis is characterized by secondary amenorrhea, dyspareunia, abnormal uterine bleeding, and infertility
Key Points
The perimenopause is a normal developmental phase progressing from the reproductive to the nonreproductive stage
Key Points
During perimenopause, women seek care for bleeding irregularities, vasomotor instability, fatigue, genital changes, and changes related to sexuality
Key Points
Alternative therapies are beneficial in relieving discomforts associated with menstrual disorders and menopause
Key Points
Osteoporosis: progressive loss of bone mass from decreasing levels of estrogen after menopause
Can be prevented or minimized with lifestyle changes and medication
Key Points
Estrogen increases calcitonin levels to prevent bone resorption and maintain bone density
Key Points
Postmenopausal women at increased risk for coronary artery disease because of changes in lipid metabolism
Sexuality continues after menopause
