Menstrual Disorder Flashcards
What will FSH do?
Stimulates ovarian follicle to develop
Stimulates granulosa cells to produce oestrogens
What is the impact of rising oestrogen on the menstrual cycle?
Inhibits FSH production
When is the LH surge?
36 hours prior to ovulation
What is the luteal phase?
Formation of corpus luteum and therefore progesterone
What is normal menstrual loss?
Lasts 4-6 days
Menstrual flow peaks day 1-2
<80ml blood loss
No clots
What is a normal menstrual cycle?
Average 28 days
But between 21-35 is normal
No IMB or PCB (post coital bleeding)
What is dysfunctional uterine bleeding?
Non-organic menorrhagia
What local disorders can cause menorrhagia?
Fibroids Adenomyosis Endovercival or endometrial polyp Cervical eversion Endometrial hyperplasia IUCD PID Endometriosis Malignancy of cervix or uterus Granulosa cells of ovary Trauma AVM
What is PID?
Infection of fallopian tubes
What systemic disorders can cause menorrhagia?
Hyper/hypothyroidism DM Adrenal diisease Prolactin disorders Disorders of haemostasis; VWD, ITP, Factor 2, 5, 6, 8, 9 deficiency Liver disorder Renal disease Anticoags
What issues surrounding pregnancy can cause menorrhagia?
Miscarriage
Ectopic pregnancy
Gestational trophoblastic disease
Postpartum haemorrhage
What is anovulatory DUB?
Extremes of reproductive age
Irregular cycle
What is ovulatory DUB?
Regular heavy periods
Due to inadequate progesterone production by corpus luteum
Investigation for DUB?
FBC
Cervical smear
TSH
Coag screen
Renal/ liver function
TVUSS (endometrial thickness, presence of fibroids and other pelvic masses)
Endometrial sampling (pipelle, hysteroscopic, dilatation and curretage)
Medical therapy for management of DUB?
Progesterones COP Danazol GNRH analogues NSAIDs; tranexamic acid Antifibrinolytics Capillary wall stabilisers
