Gynae Problems Flashcards
what is menorrhagia?
heavy menstrual bleedin
what is metrorrhagia?
regular intermenstrual bleeding
what is oligomenorrhea?
menses at intervals of >35days
OR
5 or less cycles a year
what is amenorrhea?
absence of menstruation >6months
primary/secondary
what local disorders can cause menorrhagia?
fibroids adenomyosis endocervical/endometrial polyp endometrial hyperplasia IUD PID endometriosis malignancy of the uterine or cervix ovarian tumours
what systemic disorders can cause menorrhagia?
endocrine disorders haematological diseases liver diseases renal disease drugs - anticoagulants
what is dysfunctional uterine bleeding?
non-organic menorrhagia
occurs in the absence of pathology
what are the management options for menorrhagia?
Mirena IUS COCP antifibrinolytics NSAIDs oral progestogens GnRH analogue/agonists
what are some causes of postcoital bleeding (PCB)?
Cervical ectropion cervical carcinoma trauma atrophic vaginitis cervicitis 2nd to STIs polyps idiopathic
what are some causes of postmenopausal bleeding (PMB)?
Atrophic vaginitis endometrial polyps endometrial hyperplasia endometrial carcinoma cervical carcinoma ovarian cancer vaginal cancer
what are the NICE guidelines on women presenting with PMB?
Women >55y/o with PMB should be investigated within 2 weeks by USS for endometrial cancer
what is the most common cause of PMB?
Atrophic vaginitis
what is atrophic vaginitis?
when the epithelium thins & breaks down in response to low oestrogen levels
what is the most common cause of menstrual irregularity?
polycystic ovarian syndrome (PCOS)
What is the Rotterdam criteria?
used to diagnose PCOS
requires at least two of the following for diagnosis:
- evidence of hyperandrogenism
- polycystic ovaries on ultrasound scan
- oligo/amenorrhea
what are features of PCOS?
obesity hypertension acanthosis nigricans acne & hirsutism irregular periods
in PCOS there is an increase in the LH:FSH ratio…true or false?
true!
LH levels are very high
FSH levels are low/normal
what is primary amenorrhea?
failure of menstruation by 16 years of age
what is secondary amenorrhea?
absence of menstruation for at least 6 months in a female that has had periods before
(not pregnancy, lactation or menopause)
what is the climateric?
The period around the beginning of the menopause
when is menopause classed as premature?
if it happens before the age of 45
what causes menopause?
it is due to a loss of ovarian follicular activity leading to a fall in oestradiol levels below that needed for endometrial stimulation
what risks are associated with HRT?
Breast cancer
VTE
Endometrial cancer
