Menstrual Disorder Flashcards
What is the function of FSH?
stimulates ovarian follicle development and granulosa cells to produce oestrogen
What inhibits FSH production during the follicular phase?
raising oestrogen and inhibin by dominant follicles
What does the declining FSH levels during the follicular phase cause?
atresia of all but the dominant follicle
What happens during ovulation?
prior LH surge with dominant follicle rutpuring and releasing oocyte
What is the main hormone produced during hte luteal phase?
progestrone
How long does menstrual loss last?
4-6 dyas
When does menstrual flow peak?
days 1-2
What volume of blood should be lost during menstruation?
<80ml
What should not be present in the blood during menstruation?
no clots
What is menorrhagia?
prolonged nad increased menstrual flow
What is metorrhagia?
regular intermenstrual bleeding
What is polymenorrhoea?
menses occurring at <21 day interval
what is polymenorrhagia?
increased bleeding and frequent cycle
What is menometrorrhagia?
prolonged menses and intermnstrual bleeding
What is oligomenorrhoea?
menses at intervals of >35 days
What is ameonrrhoea?
absence of menstruation >6 months
What accounts for 50% of menorrhagia?
dysfunctional uterine bleeding- absence of pathology
What are fibroids?
benign tumours of the myometrium which are not painful
What is cervical eversion?
endocervical epithelium (columnar) pouted out into vagina
What is the most common cause of PID?
chlamydia
What is adenomyosis?
endometrium is presenti n myometrium- pain
What is endometriosis?
endormetrium not conifned to uterus, tissue is found elsewhere
What are the endocrine cuases of menorrhagia?
hyper/hypothyroidism; DM; adrenal disease; prolactin disease
What sydnrome is molar pregnancy also part of?
gestational trophoblastic disease
What is dysfunctional uterine bleeding divided into?
anovultary and ovulatory
What is the most common type of dysfunctional uterine bleedings?
anovultary- 85%
What causes ovulatory DUB?
inadequate progesterone production by corpus luteum
Who is anovulatory DUB more common in?
obese women; extrenes of reproductive life
Who is ovulatory more common in?
women aged 35-45
How can anovulatory and ovulatory DUB be distinguished?
anovulatory has irregular cycle whereas ovulatory get regular heavy periods
What is the cut off for normal endometrial thickness of transvaginal USS?
4 mm
What should be done in all women >40 with menorrhagia?
pipelle biopsy to rule out endometrial carinoma
What are progestogens?
synthetic analogues of progesterone which has a longer half like
What is the problem with GnRH analogues?
stop periods but risk of osteoporosis
What are the surgical mx options for DUB?
endometrial resection/ablation; hysterectomy
What is the problem with endometrial resection/ablation?
20% chance periods will not change
What is the primary cause of distortion in patients?
bayesian reasoning
