Disorders of the Uterus Flashcards
Endometriosis
Infertility
Pain
Irregular bleeding
Occurs in menstruating women
Is estrogen dependent
Endometriosis
Endometriosis Patho
Endometrial cells grow in pelvis and abdomen and cause problems
Endometriosis risks
Family hx
Nulliparity
Long periods
Tall, thin, low BMI
Endometriosis S/S
Dysmenorrhea Pelvic pain Dyspareunia GI Infertility Mass Urinary problems
Chocolate cyst of the ovary
Endometriosis of the ovary
Imaging for endometriosis
Pelvic laproscopy (standard) Transvaginal US
Endometriosis tx
OCP's GnRH agonists Medroxyprogesterone acetate Danazol Aromatase inhibitors
Leiomyoma (fibroids)
Benign smooth muscle tumor of uterus Estrogen dependent Occur in childbearing age Grow during pregnancy Rarely malignant Affects 30% of women
Leiomyoma (fibroids) complications
Can interfere w/ fetal growth and nutrition
Increases risk of abortion and preterm labor
Leiomyoma (fibroids) S/S
Menorrhagia Bleeding btw periods Pain, pressure Stress incontinence Infertility
Leiomyoma (fibroids) Dx
Transvag ultrasound
Hysteroscopy
Leiomyoma (fibroids) Tx
Medroxyprogesterone for several weeks
GnRH-a
What do GnRH agonists do?
Put the patient into menopause while on the med.
Adenomyosis
Commonly confused w/ fibroids
Uterine wall thickens and enlarges
Adenomyosis Dx
DIffusely enlarged uterus
Menorrhagia
Dysmenorrhea
Abd pain
Adenomyosis Tx
OCP
NSAIDS
Hysterectomy for severe dz
Uterine Prolapse
Pelvic floor muscles and ligaments stretch causing uterus to descent into vaginal canal.
Often affects postmenopausal women who have had vaginal births
Uterine Prolapse S/S
Sensation of heaviness and pulling in pelvis
Urinary difficulties
BM issues
Low back pain
Uterine Prolapse Tx
Healthy weight Kegel exercises Avoid heavy lifting Estrogen replacement Vaginal pessary
Anovulatory bleeding features
Irregular or infrequent bleeds Flow light to excessively heavy Amenorrhea Menorrhagia Irregular intervals, long bleeds
Anovulation Patho
Lack of progesterone leads to no follicular development
Prolonged estrogen stimulation
excessive endometrial proliferation
Anovulation increases risk for?
Endometrial CA
Anovulation tx
OCP
or
Cyclic progesterone
Ovulatory uterine bleeding
Regular intervals of menorrhagea lasting longer than 7 days.
vWD is most common cause
Tx for ovulatory uterine bleeding
If no bleeding disorder then: Provera for 3-6 months or Mirena IUD OCP, progesterone NSAIDS
Most common cause of post-menopausal bleeding
Endometrial atrophy and endometrial polyps
