Lecture 7: Menstruation, Contraception, and Vaginal Infections Flashcards
Menarche
First period
- starts at age of 12. range is (11-14.5)
- influenced by factors like race, genetics, nutritional status, body mass
Period cycle
- Avg cycle is 28 days
- Range is 24-38 days,
- Generally 3-7 days
Dysmenorrhea
painful menstruation
- prevalence is highest in adolescence, 93% affected
- generally develops within 6-12 months of menarche
Premenstrual Syndrome
physical disorder or physical/emotional/behavioral changes that occur during luteal phase
Amenorrhea
absence of menstruation
Menorrhagia
abnormally heavy or prolonged bleeding
metrorrhagia
abnormal bleeding from uterus
oligomenorrhea
infrequent menstrual flow
Primary dysmenorrhea
- appropriate to use self-care measures to treat
- as soon as 6-12 months after menarche but typically several years after
- no pain during other parts of cycle,
- more likely to be regular with normal blood loss
- NSAIDS help
Prostaglandins
stimulate uterine contractions to expel menstrual fluid and control bleeding as the endometrium sloughs
Leukotreines
cause vasoconstriction and uterine contractions
Dysmenorrhea Risk factors contributing to it
- young age
- nulliparity
- early menarche (prior to age 12)
- heavy menstrual flow
- tobacco smoking
- low fish consumption
- BMI above 30 or below 20
- PMS symptoms
- stress, anxiety, depression
Secondary Dysmenorrhea
- mid to late 20s or older, usually 30s and 40s
- more likely irregular menses, menorrhagia or metrorrhagia is more common
- pattern and duration of pain can vary with cause these changes in pattern or intensity may indicate secondary disease
- There may be pain during other parts of the menstrual cycle
- NSAIDS don’t really help
Primary Dysmenorrhea symptoms
fatigue, headache, nausea, change in appetite, backache, dizziness, irritability, depression
Secondary Dysmenorrhea symptoms
vary according to cause but may include dyspareunia (genital pain) and pelvic tenderness
Ovulation
each month, an egg matures in the ovaries and is released through the fallopian tube into the uterus
Implantation
- if the egg is fertilized by the sperm, it implants on the wall of the uterus
- Leads to pregnancy
Egg is not fertilized
- it then exits the body through the cervix and vagina
- Leads to menstruation
Menstruation
- Hormone levels drop and the endometrium (uterine lining) breaks down
Primary Dysmenorrhea Exclusions for Self-Care
- severe dysmenorrhea and/or menorrhagia
- symptoms inconsistent with primary dysmenorrhea
- history of Pelvic Inflammatory Disease (PID), infertility, irregular menstrual cycles, endometriosis, ovarian cysts
- use of IUD/IUCs
- allergy or intolerance to aspirin or NSAIDs
- use of warfarin, heparin or lithium
- active GI disease
- bleeding disorders
First line treatment for dysmenorrhea
Ibuprofen or Naproxen
- begin therapy at onset of menses and pain
- treatment may be started 1-2 days prior to expected menses to improve relief
- most effective when taken on schedule
Using Acetaminophen for dysmenorrhea
- weak prostaglandin inhibitor
- may be able to treat mild symptoms
Using Aspirin for dysmenorrhea
- may increase menstrual flow
- moderately treats minimal symptoms
Non-pharmacological treatment for dysmenorrhea
- sleep
- hot bath
- heating pad
- exercise
- avoid smoking
- exposure to secondhand smoke