Menstrual Cycle Interview Flashcards
What are the key points to establish when interviewing a woman about her menstrual cycle?
Frequency
Duration
Amount of blood loss
What must be considered when a woman of child bearing age presents with amenorrhoea or abnormal uterine bleeding?
Pregnancy
How do you establish the frequency of a menstrual cycle?
Ask about time between last day of 1 period and 1st day of next
What is the normal duration of a menstrual cycle?
21-35 days
Typical = 28 days
Variation of 1-2 days in most women
If a woman has a greater variation than one to two days within her menstrual cycle, what should be documented?
Shortest and longest times between cycles
What is the typical length of a woman’s menstruation?
4-5 days
What is amenorrhoea?
Absence of menstruation during reproductive years
To what time frame is amenorrhoea applied to?
Not menstruated for >6 mths
What is primary amenorrhoea?
Late menarche
What is secondary amenorrhoea?
Established cycles and then ceases menstruation
What is the most common cause of amenorrhoea?
Pregnancy
What is oligomenorrhoea?
Previously regular cycles
Infrequent menstruation
Flow becomes lighter
How many periods is a woman having if she has oligomenorrhoea?
4-9/year
What is polymenorrhoea?
Interval between menstrual period <21 days
How much blood is lost during menstruation?
20-60 mL
How much blood loss during menstruation is considered abnormal?
More than 80 mL
How can you quantify blood loss during menstruation?
Number and size of tampons/pads
What is menorrhagia?
Abnormally heavy menstruation over at least several consecutive cycles
When does menorrhagia usually occur?
Just before menopause
What can menorrhagia cause?
Iron deficiency anaemia
Significant impact on quality of life
What do you want to know about the quality of the period?
Colour of blood
- How it varies during period
Does blood contain clots?
How do you interrogate the severity of a period?
Amount of blood loss
Need to know why they’re changing
How do you interrogate the time course of a period?
Frequency Duration Any change Irregular: shortest and longest cycle lengths Date of last menstrual period In younger women: age of menarche
How do you interrogate the context of a period?
Circumstances that may relate to changes in cycle
- Pregnancy
- Peri-menopausal
How do you interrogate the aggravating factors of a period?
Anything directly impacts on woman’s menstrual cycle
Common causes of amenorrhoea
- Stressful events
- Significant weight loss
How do you interrogate the relieving factors of a period?
Treatments tried for menstrual irregularity
How effective they’ve been
How do you interrogate the associated features of a period?
Pelvic pain = dysmenorrhoea Intermenstrual and post-coital bleeding Symptoms of anaemia Menopausal symptoms Any bleeding disorders Anti-coagulant medication
