Lecture 7 Flashcards
Menstrual Related Disorders
What is the pathophysiology of dysmenorrhea ?
Low progesterone –> high PG –> sensitive afferent nerves –> pain
vasopressin –> endometrial contracts ad arterioles constrict –> uterine ischemic –> pain
What are the risks factors of dysmenorrhea ?
early menarche ( <12 years)
heavy and duration of mens
FmHx
Smoking
Stress
depression
nulliparity
What are the CAM products that has evidence to help dysmenorrhea ?
ginger and vitamin B1
What are the PHARM to help dysmenorrhea ?
NSAID, COC, POP and LNG IUS
Who is mostly affected by abnormal uterine bleeding ?
women 30-40 years
what is the normal menstrual cycle ?
Normal cycle ( 21 to 35 days) & bleeding ( 1-7 days) & 1 maxi pad/tampon / 3 hours
What is AUB ovulatory ( abnormal uterine bleeding) ?
Menorrhea: regular menstrual but HEAVY flow
What is the cause of AUB ?
imbalance of TXA and PG
What is AUB Anovulatory Menstrua cycle ?
irregular, unpredictable
low progesterone that stop ovulation –> more estrogen to act on the endotrium
how is AUB classified ?
PALM - stuctural
COEIN - non-structural
What are the other labs that can be looked for AUB ?
CBC, TSH, Prolactin, coagulation panel and platelet count
What are the PHARM for AUB ? ( not extreme)
NSAIDs / Tranexemic acid
POP / DMPA
CHC / LNG IUS
Pts has heavy bleeds due to fibroids ? PHARM ?
GnRH agonist/ antagonist
Pt has heavy bleeding due to HIGH prolactin ?
stops prolactin production
bromocriptine, cabergoline
what is myomectomy ?
removal of fibroids
