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PR3152 > Menstrual cycle disorders > Flashcards

Menstrual cycle disorders Flashcards

1
Q

What is the definition of amenorrhea

A

No menstrual bleeding in a 90 day period

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2
Q

Risk factors for secondary amenorrhea (absence of period for 90 days in previously menstruating females)

A
  1. <25 yo with Hx of menstrual irregularities
  2. Competitive athletes
  3. Massive weight loss
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3
Q

Etiologies of amenorrhea

A
  1. Anatomical causes (eg. pregnancy, uterine structural abnormalities)
  2. Endocrine disturbances –> chronic anovulation
  3. Ovarian insufficiency/ failrue
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4
Q

Non-pharmacological treatment of amenorrhea

A
  1. Weight gain
  2. Reduction of exercise intensity
  3. Stress management
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5
Q

Pharmacological treatment for amenorrhea

A
  1. COC
  2. Estrogen only
  3. Progestin only
  4. Copper IUD
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6
Q

Definition of Menorrhagia

A

Heavy menstrual bleeding
- Menstrual blood loss >80mL per cycle or bleeding >7 days per cycle

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7
Q

Contraceptives for treatment of menorrhagia

A
  1. COC
  2. Progestin IUD
  3. Progestin-only pill
  4. Progestin injection
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8
Q

Non-contraceptive treatment for menorrhagia

A
  1. NSAIDs during menses
  2. Tranexamic acid during menses
  3. Cyclic progesterone (no contraceptive effect)
  4. Endometrial ablation or hysterectomy
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9
Q

Definition of dysmenorrhea

A
  1. Crampy pelvic pain with or just before menses
  2. Secondary is caused by endometriosis (endometrium grows outside of uterus)
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10
Q

Causative factor responsible for dysmenorrhea

A

Prostaglandins and leukotrienes –> vasoconstriction –> cramps

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11
Q

Non-pharmacological management of dysmenorrhea

A
  1. Topical heat therapy
  2. Exercise
  3. Acupuncture
  4. Low-fat vegetarian diet
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12
Q

Pharmacological treatment of dysmenorrhea

A
  1. NSAIDs (1st line)
  2. COC (2nd line)
  3. Progestin injection/ IUD (3rd line) –> to render patients amenorrhic
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13
Q

What does Premenstrual syndrome (PMS) means?

A
  1. Cyclic pattern of symptoms occurring 5 days before menses that resolve at the onset of menses
  2. Most patients do not report impairment of daily activities
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14
Q

What are the somatic symptoms of PMS (physical)?

A
  1. Bloating
  2. Headache
  3. Weight gain
  4. Fatigue
  5. Dizziness/ nausea
  6. Appetite changes
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15
Q

What are the Affective symptoms of PMS (mood)?

A
  1. Anxiety/ depression
  2. Angry outburst
  3. Social withdrawal
  4. Forgetfulness
  5. Tearful
  6. Restlessness
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16
Q

Pharmacological therapy for PMS

A
  1. Selective Serotonin Reuptake Inhibitors (SSRIs)
  2. COC –> for physical symptoms not for Affective symptoms
17
Q

What is Polycystic Ovary Syndrome (PCOS)?

A

Ovaries produce an abnormal amount of androgens –> small cysts form in ovaries

18
Q

Clinical presentation of PCOS

A
  1. Menstrual irregularities
  2. Androgen excess (acne, oily skin, hirsutism, obesity)
  3. Metabolic disorder/ insulin resistance –> increase risk for DM and CVS disease
19
Q

Treatment for PCOS

A
  1. COC (consider anti-androgenic progestin)
  2. Metformin

PR3152 (7 decks)

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