Gyn issues Flashcards
amenorrhea
-absence of menses during reproductive years
-primary and secondary
two types of primary amenorrhea
-absence of menses by age 14 with absence of development of secondary sexual characteristics
-absence of menses by age 16 with normal development of secondary sexual characteristics
mgmt of primary amenorrhea
-correct problem, any underlying disorder
-estrogen replacement
secondary amenorrhea
-absence of regular menses for 3 cycles or irregular menses for 6 months in women who have previously menstruated regularly
-ex: pregnancy
-Normal for children around 12yo who have a period once but havent had another in a long time (unless she is sexually active)
mgmt of secondary amenorrhea
-cyclic progesterone
-oral contraceptive
dysmenorrhea
-painful menstruation
-primary & secondary
primary dysmenorrhea (spasmodic)
-increased prostaglandin production which causes cramping & pain during menstruation, normal
-mgmt: birth control, ibuprofen
secondary dysmenorrhea (congestive)
-pelvic or uterine pathology
-cause: endometriosis (most common) or fibroids
-mgmt: find underlying problem, contact OBGYN
assessment of secondary dysmenorrhea
-pmh
-sexual hx
-menstrual hx
-bimanual pelvic exam
s/s of dysmenorrhea
pain, n/v, diarrhea, fatigue, fever, h/a, dizziness; bloating, water retention, weight gain, muscle aches, food cravings, breast tenderness
dysmenorrhea pt education
-comfort measures: heat, lifestyle changes, pain relief
-Exercise to increase endorphins and suppress prostaglandin release.
-Limit salty foods to prevent fluid retention.
-Increase water consumption to serve as a natural diuretic.
-Increase fiber intake with fruits and vegetables to prevent constipation.
-warmth: heating pads, warm bath/showers, warm beverages
-Keep legs elevated while lying down or lie on your side with knees bent.
-stress mgmt and relaxation techniques
-Stop smoking and decrease alcohol use which causes vasoconstriction.
abnormal uterine bleeding
-painless endometrial bleeding that’s prolonged, excessive, and irregular and not attributed to any underlying structural or systemic disease
-r/t to hormone disturbance
-tx involves finding underlying cause
types of abnormal uterine bleeding
-menorrhagia: abnormally heavy flow or prolonged flow
-metrorrhagia: in between, irregular, frequent bleeding
-menometrorrhagia: prolonged or excessive bleeding at irregular intervals; will become anemic, may need blood transfusion depending on heaviness of flow
premenstrual syndrome
recurrent physical, emotional, and behavioral symptoms that occur during the luteal phase or last half of the menstrual cycle and resolve with the onset of menstruation
PMDD mgmt
-vitamin supplements
-diet changes, limit caffeine and simple carbs
-exercise
-lifestyle, rest
-meds: sarafem/rozac- fluoxetine… doesn’t rely on therapeutic dose, levels out mood, start 14 days before cycle and end when cycle starts
