Dysmenorrhea or Amenorrhea Flashcards
Why should copper IUD not be used for dysmenorrhea?
Can lead to even heavier bleeding; is only used for contraception
How do OCPs relieve dysmenorrhea?
Progestin –> endometrial atrophy –> decreased prostaglandin production –> improved dysmenorrhea
Risks of depo medroxyprogesterone acetate
Gaining weight
Depression
What are causes of secondary dymenorrhea?
Endometriosis
Adenomyosis
Fibroids
Pelvic inflammatory disease from STIs (e.g. Chlamydia) or adhesions
Ovarian cysts
in whom are oral contraceptive pills contraindicated?
Smokers
>age 35
What demographic more likely has adenomyosis?
Older multiparous women
Women >45 yo (late reproductive years and older) with abnormal uterine bleeding should receive what?
Endometrial biopsy - to rule out endometrial hyperplasia or cancer
How would pathology show endometriosis?
Endometrial glands/stroma and hemosiderin-laden macrophages outside the uterine cavity
What is indicated by well-circumscribed, non-encapsulated myometrium?
Fibroids
What fibroid location is less likely to cause pain with menstruation?
Subserosal
Endometrial polyps are most common in which women, and how do they present?
Age 40-50; increased menstrual flow with increased cramping, as well as intermenstrual spotting
What is red/carneous degeneration?
Fibroid growth in pregnancy that may become symptomatic due to hemorrhagic changes associated with rapid growth
In whom might myotectomy be preferred over hysterectomy?
Younger patients with fibroids who want to preserve fertility
How long after GnRH agonist cessation do things return?
Hot flashes end by 1-2 months after
Myoma and uterine size return to pretreatment levels in 3-4 months
When does fibroid degeneration happen?
When it outgrows its blood supply and is independent of the use of GnRH agonist
