Disorders of Menstruation Flashcards
Define primary and secondary menstruation
- Primary amenorrhea - failure to establish menstruation by 16 years
- Secondary amenorrhea - cessation of previously normal menstruation for ≥ 6 months
Define oligomennorhoea
Infrequent menstruation > 35 days
Define menorrhagia
Heavy menstrual bleeding (HMB) - excessive menstrual blood loss over consecutive cycles
Define dysmenorrhoea
Pain during menses, associated with ovulatory cycles
Define intermenstrual bleeding (IMB)
Bleeding occurring at abnormal parts of the cycle
Define dysfunctional uterine bleeding (DUB
Heavy and irregular menstrual bleeding that occurs secondary to anovulation
What is premenstrual syndrome
- Cyclical disorder, occurring in latter half of menstrual cycle
- Symptoms could be physical or psychological and resolve with onset of menstruation
What is premenstrual dysphoric disorder
Severe end of spectrum with extreme mood symptoms
What are common causes of menorrhagia
- Uterine fibroids
- Uterine polyps
- Endometrial cancer
- Bleeding diathesis - bleeding when brushing teeth
- Copper IUCD - copper inserted as birth control
- Drugs - eg. Warfarin
Explain Turner’s syndrome
- Problem of ovary responding to LH and FSH
- Increase in GnRH causing increase in LH and FSH
- Women not able to conceive and are shorter than average
What do you examine for suspected menstrual dysfunction
- General, abdominal, speculum, bimanual
- Presence or absence of secondary sexual characteristics
- Appearance of known chromosomal abnormalities or abnormal facies (facial expression correlating to disease)
- Swellings/lumps/masses, discharge, pattern of hair growth
What investigations would you conduct for suspected menstrual dysfunction
- Blood, hormone profile - gonadotrophins (FSH and LH), karyotype, thyroid function test, full blood count
- Imaging - USS, MRI
- Hysteroscopy - camera into uterus
- Laparoscopy - camera inside abdomen
- Can see uterus, fallopian tubes
