Menstrual Disorder Flashcards
what are the 3 phases of the menstrual cycle
Follicular phase
Ovulation
Luteal Phase
what stimulates the ovarian follicle development
FSH
what happens in the follicular phase
FSH stimulates ovarian follicle development & granulosa cells to produce oestrogens
Rising oestrogen & inhibin by dominant follicles inhibit FSH production
Declining FSH levels cause atresia of all BUT dominant follicle
what happens in the ovulation stage
Prior LH surge
Dominant follicle ruptures and releases oocyte
what happens in the luteal phase
Formation of corpus luteum
Progesterone production
Luteolysis 14 days post-ovulation [breakdown of corpus luteum]
what are the stages of the endometrial events in the menstrual cycle
proliferative phase
luteal phase
menstruation
over what days is the proliferative phase
day 5 to 14
what happens in the proliferative phase
Oestrogen-induced growth of endometrial glands and stroma
what happens in the luteal phase (endometrial events)
Progesterone-induced glandular secretory activity
Endometrial apoptosis and subsequent menstruation
what happens in the menstruation phase
Arteriolar constriction and shedding of functional endometrial layer
Fibrinolysis inhibits scar tissue formation
what is normal menstrual loss
lasts about 4-6 days
< 80 ml
no clots
what is menorrhagia
prolonged and increased menstrual flow
what is metrorrhagia
regular intermenstrual bleeding
what is Polymenorrhoea
menstruation occurring at < 21 day interval
what is polymenorrhagia
increased bleeding and frequent cycles [due to the cycles being shorter]
what is menometrorrhagia
prolonged menstruation and intermenstrual bleeding
what is amenorrhoea
absence of menstruation > 6 months
what is Oligomenorrhoea
menstruation at intervals of > 35 days
how can causes of menorrhagia be split
organic
- presence of pathology
non-organic
- absence of pathology
- a.k.a dysfunctional uterine bleeding
what are some examples of organic cases of menorrhagia
fibroids adenomyosis endocervical/endometrial polyp IUCD - copper coil PID endometriosis malignancy
Von Willebrand’s disease
ITP Factor II, V, VII and XI deficiency
Anticoagulants
Miscarriage
Ectopic pregnancy
Gestational trophoblastic disease
Post partum haemorrhage
how is a diagnosis of dysfunctional uterine bleeding (DUB) made
by exclusions
how can causes of DUB be split
Anovulatory
Ovulatory
what is anovulatory DUB
85% of all DUB
Occurs at extremes of reproductive life
Irregular cycle
More common in obese women
what is ovulatory DUB
More common in women aged 35-45 years
Regular heavy periods
Due to inadequate progesterone production by corpus luteum
