Menarche, Puberty and Menstrual Disorders Flashcards
Menarche
1st occurrence of menstruation
Primary Amenorrhea
- Absence of menarche by age 13 WITHOUT secondary sexual development
OR - Absence of menarche by age 15 WITH secondary sexual development
Secondary Amenorrhea
Absence of menstruation for at least 6 months
With secondary amenorrhea, levels of what should be checked to rule out pregnancy?
hCG
It is rare to remain amenorrheic for greater than?
90 days
Polymenorrhea
Abnormally frequent menses @ intervals of < 21 days
Oligomenorrhea
Abnormally infrequent menses @ intervals of > 35 days
Menorrhagia
Excessive bleeding and/or prolonged menses occurring at regular intervals
Metrorrhagia
Irregular episodes of uterine bleeding
Menometrorrhagia
Heavy AND irregular uterine bleeding
Intermenstrual bleeding
Scant bleeding at ovulation for 1 - 2 days
With Menorrhagia, the excessive bleeding is usually defined as > ___ mL
80
AUB
Abnormal Uterine Bleeding
What is the classification system for AUB?
PALM-COEIN
What is AUB?
Abnormal uterine bleeding that is NOT attributed to:
- medications
- blood disease
- systemic disease
- trauma
- organic conditions
When do most AUB occur?
Around Menarche or Premenopausal
AUBs are usually caused by disruptions to the?
Hypothalamic-Pituitary-Ovarian axis that results in Anovulation (no egg released)
Structural changes in the classification system for AUB?
PALM
P in PALM-COEIN
Polyps
A in PALM-COEIN
Adenomyosis
What is adenomyosis?
Extension of endometrial glands into the myometrium
L in PALM-COEIN
Leiomyoma
What is leiomyoma?
Fibroids - usually benign tumor in myometrium
M in PALM-COEIN
Malignancy
C in PALM-COEIN
Coagulopathy
O in PALM-COEIN
Ovulatory dysfunction
E in PALM-COEIN
Endometrial
I in PALM-COEIN
Iatrogenic
N in PALM-COEIN
Not yet classified
Tanner stages classify normal?
Pubertal development
What is puberty?
Development of secondary sex characteristics and the ability to reproduce
Average duration of puberty?
4-5 years
Between what ages does puberty usually occur?
10-16
What 3 things can determine the onset of puberty?
Genetics
Geographic location
Nutritional status
What race normally begins puberty earlier?
African Americans
What geographic location normally begins puberty earlier?
Metropolitan areas at sea level
What nutritional status level will begin puberty earlier?
Obese children
What nutritional status level will begin puberty later?
Malnourished
What inhibits the H-P-O axis between 4 and 10 years of age
CNS (Gonadostat)
Main 4 stages of puberty
- Thelarche
- Pubarche/Adrenarche
- Maximal growth
- Menarche
Thelarche
Breast development
Pubarche/Adrenarche
Pubic and axillary hair growth
Tanner stages for female breast development
- Preadolescent
- Enlargement of areolar region
- Further enlargement of breast and areolar region
- Projection of areola and papilla
- Mature
Tanner stages for female pubic hair growth
- Preadolescent - no hair
- Sparse hair along labia
- Hair spreads and is darker and coarser
- No spread to medial thigh
- Inverted triangle pattern WITH some on medial thigh
