Menstrual Cycle Disorders

Question 1

Amenorrhea

Answer 1

Absence of menses
Primary:
Absence of mentruation w/o secondary sexual characteristics
Etiology: multiple causes
* Weight gain/loss/ anorexia
* Congenital abnorm
* Sports/Excessive exercise
* Medical conditions: Cushing’s disease, polycystics ovaries, cystic fibrosis, hypothyroidism
* Preg

Secondary:
Absense of menses x3 cycles or 6 months in women who have previously menstrated reg
Etiology: many of the same/ most likely is preg, breast feeding, malnutrition, chemo or radiation some med, early menopause

Question 2

Assesment of Amenorrhea

Answer 2

History/Physical
Labs: Preg test, hormone levels
Treatment based on the underlying causes
* oral contraceptives
* Meds to correct labs findings (thyroid med)

Question 3

Dysmenorrhea

Answer 3

Painful menstruations = CRAMPS
eitology: Increased prostagladins casuing painful uterine ctxs
Clinical manifestions” debilitating pain
Assesment: detailed gyn history & sexual history
Treatment: pain relief, treat infections

Nursing Management
Edu: increase excerise/ limit salt, stop smoking, lose weight, stress reduction

Question 4

Premenstrual Syndrome (PMS

Answer 4

Wide range of symptoms that begin th 2nd half of cycle & resolve w/ onset of menstruation
Etiology: unknown; perhaps hormonal, maybe serotonin
Clinical mani: irritability, tension, dysphoria
Diagnosis: one of the following affective & somatic sym during 5 day b/4 menses in each of the previous 3 cycle

Question 5

Affective

Answer 5

Depression, angry, outburst, irritability, anxiety

Question 6

Somatic

Answer 6

Breast tenderness, abd bloating h/a , edema

Question 7

Endometriosis

Answer 7

Most common gyn disease
functioning endometrial tissue outside the uterus
Respond to norm hormonal cycle
Cause unknown

Question 8

S/S of Endometriosis

Answer 8

Infertility
Menstrual problems
* Dysmenorrhea & Hypermenorrhea ( very heavy periods)
* Irreg, freq menses, mid-cycle spotting

Dyspareunia, painful urination/ bowel movement
Chronic pelvic pain

Question 9

Treatment of Endometriosis

Answer 9

Suppress estrogen & progesterone
Surgery
* remove endo lesioins/reduces pain
* Hysterectomy- eliminate pain but total loss of fertility

Medicatoins
* NSAIDS
* Oral Contraceptives, progestins

Question 10

Fibroids

Answer 10

Treatment: symptoms relief reductions of tumor size
Med
Surgery
* Uterine artery embolizations: disrupt fertility
* Myomectomy: remove the fibroid
* Laser surgery: can cause adhesion/ furhter pain
* Hysterectomy: remove the uterus

Question 11

Menopause

Answer 11

Climacteric/Peri Menopause
* Transitional period when ovarian function and hormone production decline
* May span 10-15 yrs

Meno
* Refers to the last menstrual cycle (1 yr after one full year w/o menses)