Menstrual Cycle Interview

Question 1

What are the key points to establish when interviewing a woman about her menstrual cycle?

Answer 1

Frequency
Duration
Amount of blood loss

Question 2

What must be considered when a woman of child bearing age presents with amenorrhoea or abnormal uterine bleeding?

Answer 2

Pregnancy

Question 3

How do you establish the frequency of a menstrual cycle?

Answer 3

Ask about time between last day of 1 period and 1st day of next

Question 4

What is the normal duration of a menstrual cycle?

Answer 4

21-35 days
Typical = 28 days
Variation of 1-2 days in most women

Question 5

If a woman has a greater variation than one to two days within her menstrual cycle, what should be documented?

Answer 5

Shortest and longest times between cycles

Question 6

What is the typical length of a woman’s menstruation?

Answer 6

4-5 days

Question 7

What is amenorrhoea?

Answer 7

Absence of menstruation during reproductive years

Question 8

To what time frame is amenorrhoea applied to?

Answer 8

Not menstruated for >6 mths

Question 9

What is primary amenorrhoea?

Answer 9

Late menarche

Question 10

What is secondary amenorrhoea?

Answer 10

Established cycles and then ceases menstruation

Question 11

What is the most common cause of amenorrhoea?

Answer 11

Pregnancy

Question 12

What is oligomenorrhoea?

Answer 12

Previously regular cycles
Infrequent menstruation
Flow becomes lighter

Question 13

How many periods is a woman having if she has oligomenorrhoea?

Answer 13

4-9/year

Question 14

What is polymenorrhoea?

Answer 14

Interval between menstrual period <21 days

Question 15

How much blood is lost during menstruation?

Answer 15

20-60 mL

Question 16

How much blood loss during menstruation is considered abnormal?

Answer 16

More than 80 mL

Question 17

How can you quantify blood loss during menstruation?

Answer 17

Number and size of tampons/pads

Question 18

What is menorrhagia?

Answer 18

Abnormally heavy menstruation over at least several consecutive cycles

Question 19

When does menorrhagia usually occur?

Answer 19

Just before menopause

Question 20

What can menorrhagia cause?

Answer 20

Iron deficiency anaemia

Significant impact on quality of life

Question 21

What do you want to know about the quality of the period?

Answer 21

Colour of blood
- How it varies during period
Does blood contain clots?

Question 22

How do you interrogate the severity of a period?

Answer 22

Amount of blood loss

Need to know why they’re changing

Question 23

How do you interrogate the time course of a period?

Answer 23

Frequency
Duration
Any change
Irregular: shortest and longest cycle lengths
Date of last menstrual period
In younger women: age of menarche

Question 24

How do you interrogate the context of a period?

Answer 24

Circumstances that may relate to changes in cycle

• Pregnancy
• Peri-menopausal

Question 25

How do you interrogate the aggravating factors of a period?

Answer 25

Anything directly impacts on woman’s menstrual cycle
Common causes of amenorrhoea
- Stressful events
- Significant weight loss

Question 26

How do you interrogate the relieving factors of a period?

Answer 26

Treatments tried for menstrual irregularity

How effective they’ve been

Question 27

How do you interrogate the associated features of a period?

Answer 27

Pelvic pain = dysmenorrhoea
Intermenstrual and post-coital bleeding
Symptoms of anaemia
Menopausal symptoms
Any bleeding disorders
Anti-coagulant medication