Disorders of Menstruation Flashcards
List terms that describe common menstrual problems
Amenorrhoea Oligomenorrhoea Menorrhagia Dysmenorrhoea Intermenstrual Bleeding (IMB) Dysfunctional Uterine Bleeding (DUB) Premenstrual syndrome (PMS)
What is primary amenorrhoea
Failure to establish menstruation by age 16.
What is secondary amenorrhoea
Cessation of periods that had been normal previously for at least 6 cycles.
What is oligomennorrhoea?
A cycle lasting more than 35 days
4-9 cycles a year
What is the term given to overly painful menstruation associated with ovulatory cycles?
Dysmenorrhoea
When you find no cause for irregular heavy bleeding associated with anovolution what term do you give it?
Dysfunctional Uterine Bleeding
How heavy does a period have to be to be classified as menorrhagia?
> 80mls per menstruation in consecutive cycles
We now also consider a subjective report f heavy bleeding even if the volume is under the cut off.
What is PMS?
Cyclical disorder that occurs in the last half of the mental cycle. Symptoms can be physical or psychological, but will resolve when menses start.
The severe end of the spectrum mood symptoms is also known as what?
Pemenstrual dysphoric disorder
If you inhibit GnRH or stop Anterior pituitary activity what will happen?
Amennorrhoea
What chromosomal anomalies can give menstrual disorders?
Mayer-Rokitansky-Kustner-Hayer Syndrome XO- Turner's Syndrome Androgen Insensitivity Syndrome Swyer Syndrome Congenital Adrenal Hyperplasia
If hormones affect menstruation which axis is the cause?
HPG
How could Fibroids or polyps give menstrual problems?
Structural anatomical problems
How does thyroid disease effect menstruation?
Overactivity increases bleeding
Why is it important to assess drug history in patients with menstruation disorders?
They can affect HPO axis
How can bleeding diathesis lead to a menstrual disorder?
Blood won’t clot properly
List 3 physiological causes of amenorrhoea
Pre-puberty
Pregnancy
Menopause
Which tissues can give amenorrhea if they fail to undergo normal endocrine control?
Hypothalamus
Pituatary
Ovary
Uterus
Which hormone class do we asses levels of to understand the severity of a menstrual pathology?
Gonadotrophins (LH and FSH)
List the structural anomalies that can lead to menstrual problems.
Agenesis or hypoplasia of genital tract Leiomyoma Imperforate hymen Asherman's syndrome (uterine adhesions) Cervical stenosis
Outline the patient presentation for imperforate hymen.
Collection of blood behind hymen extending the uterus up into the abdomen gives a cyclical pain, abdominal swelling and a blue tinge to the vaginal opening in young girls.
Which ducts can fuse incorrectly and give uterine problems?
Mullherian
List causes of Mennorhagia
Leiomyoma Polyps Endometrial Cancer Bleeding Diathesis Copper IUCD Anticoagulants
What causes irregular periods?
STIs/PID Cervical ectopy (post coital bleed) Endometrial pathology Ovarian cyst secreting homones Hormonal contraceptions (progesterone onlys)
