Menstrual Disorder

Question 1

When does luteolysis occur?

Answer 1

14 days post ovulation

Question 2

How many days does menstrual loss usually last for?

Answer 2

4-6

Question 3

Menstrual flow peaks at which days?

Answer 3

Days 1-2

Question 4

Term for: prolonged and increased menstrual flow?

Answer 4

Menorrhagia

Question 5

Term for regular intermenstrual bleeding

Answer 5

Metrorrhagia

Question 6

Menses occurring at less than 21 day interval

Answer 6

Polymenorrhoea

Question 7

Increased bleeding and frequent cycle

Answer 7

Polymenhorrhagia

Question 8

Prolonged menses and intermenstrual bleeding

Answer 8

Menometrorrhagia

Question 9

What is menometrorrhagia?

Answer 9

Prolonged menses and intermenstrual bleeding

Question 10

Absence of menstruation > 6 months

Answer 10

Amenorrhoea

Question 11

Menses at intervals of >35 days

Answer 11

Oligomenorrhoea

Question 12

Difference between organic and non-organic causes of menorrhagia

Answer 12

Organic = presence of pathology
Non-organic = absence of pathology (50% of causes, also known as dysfunctional uterine bleeding)

Question 13

What is adenomyosis?

Answer 13

Glandular tissue within the myometrium (like endometriosis but wrong layer)

Question 14

What causes ovulatory dysfunctional uterine bleeding?

Answer 14

Due to inadequate progesterone production but corpus luteum

Question 15

What happens due the luteal phase?

Answer 15

The corpus luteum forms and progesterone is produces. Luteolysis occurs 14 days post-ovulation

Question 16

What is the hormone of pregnancy?

Answer 16

Progesterone (Monica told me this)

Question 17

How much blood is usually lost in a period?

Answer 17

less than 80mls, no clots

Question 18

Bleeding disorders that could cause menorrhagia?

Answer 18

Von Willebrand’s disease
ITP
Factor deficiencies

Question 19

Endocrine disorders that could cause menorrhagia

Answer 19

Hyper/hypothyroidism
Diabetes
Adrenal disease
Prolactin disorders

Question 20

Which is more common - anovulatory or ovulatory dysfunctional uterine bleeding? (DUB)

Answer 20

Anovulatory 85%

Question 21

When does anovulatory DUB occur and when does ovulatory DUB occur?

Answer 21

Anovulatory - extremes of age, irregular cycle

Ovulatory - women aged 35-45 years. REGULAR heavy periods

Question 22

Who is more likely to suffer anovulatory DUB?

Answer 22

Obese women

Question 23

Investigations for DUB

Answer 23

• full blood count
• cervical smear
• TSH
• coagulation screen/clotting tests
• renal/liver function tests
• transvaginal ultrasound scan
• endometrial sampling

Question 24

First line management for dysfunctional uterine bleeding?

Answer 24

-progesterone containing IUCD (mirena coil)

Question 25

Surgical managment of DUB?

Answer 25

• endometrial resection/ablation

- hysterectomy