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Reproductive & Sexual Health > Menstrual Disorder > Flashcards

Menstrual Disorder Flashcards

1
Q

FSH stimulates ______ ______ development & ______ cells to produce oestrogen

A

FSH stimulates ovarian follicle development & granulosa cells to produce oestrogen

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2
Q

Raising oestrogen & inhibins by dominant follicles inhibit ___ production

A

Raising oestrogen & inhibins by dominant follicles inhibit FSH production

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3
Q

Declining FSH levels cause ____ of all but dominant follicle

A

Declining FSH levels cause atresia of all but dominant follicle

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4
Q

Describe ovulation

A

Prior LH surge, dominant follicle ruptures and releases oocytes

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5
Q

Describe the luteal phase

A

Formation of corpus lute

Progesterone production

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6
Q

When does luteolysis occur?

A

14 days post-ovulation

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7
Q

Describe the proliferative phase

A

Oestrogen-induced growth of endometrial glands and stroma

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8
Q

Describe the luteal phase

A
  • Progesterone-induced glandular secretory activity
  • Decidualisation in late secretory phase
  • Endometrial apoptosis and subsequent menstruation
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9
Q

Describe menstruation

A

Arteriolar constriction and shedding of functional endometrial layer
Fibrinolysis inhibits scar tissue formation

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10
Q

What is a normal level of menstrual loss?

A

Usually lasts 4-6 days
Menstrual flow peaks day 1-2
<80 ml per menstruation
No clots

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11
Q

What is a normal menstrual cycle?

A

Average 28 day cycle
Between 21 to 35 days cycle
No IMB or PCB

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12
Q

Define menorrhagia

A

Prolonged and increased menstrual flow

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13
Q

Define metrorrhagia

A

Regular intermenstrual bleeding

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14
Q

Define polymenorrhoea

A

menses occurring at a <21 day interval

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15
Q

Define menometrorrhagia

A

Prolonged menses and intermenstrual bleeding

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16
Q

Amenorrhoea

A

Absence of menstruation > 6 months

17
Q

Oligomenorrhoea

A

Menses at intervals of > 35 days

18
Q

What are the two categories of menorrhagia?

A

Organic

Non-organic

19
Q

What is non-organic menorrhagia also known as?

A

Dysfunctional uterine bleeding

20
Q

What are the causes of local organic menorrhagia

A

Local disorders

  • fibroids
  • adenomyosis
  • endocervical or endometrial polyp
  • cervica eversion
  • endometrial hyperplasoa
  • IUCD
  • PID
  • endometriosis
  • malignancy of cervix or uterus
  • hormone producing tumours
  • trauma
  • AV malformation
21
Q

What are the causes of systemic organic menorrhagia

A 
Endocrine disorders
Disorders of haemostasis
Liver disorders
Renal disease
Drugs
22
Q

What endocrine disorders cause menorrhagia?

A

Hyper/hypothyroidism
Diabetes mellitus
Adrenal disease
Prolactin disorders

23
Q

What disorders of haemostats cause menorrhagia?

A

Von willebrand’s disease
ITP
Factor II, V, VII and XI

24
Q

Which drugs cause menorrhagia?

A

Anticoagulants

25
Q

What complications of pregnancy cause menorrhagia?

A

Miscarriage
Ectopic pregnancy
Gestational trophoblastic disease

postpartum haemorrhage

26
Q

What is Dysfunctional uterine bleeding divided into?

A

Anovulatory (85%)

Ovulatory

27
Q

When does anovulatory DUB occur

A

Extremes of reproductive life

28
Q

When does ovulatory DUB occur?

A

Women aged 35-45 years

29
Q

What causes ovulatory DUB?

A

Inadequate progesterone production

30
Q

What investigation should be done for DUB?

A
  • FBC
  • cervical smear
  • TSH
  • Coagulation screen
  • renal/liver function tests
  • transvaginal ultrasound
    > endometrial thickess
    > fibroids and other pelvic masses
    -endometrial sampling
    >pipette biopsies
    hysteroscopic directed
    dilatation and curettage (D &C)
31
Q

What is the non-surgical management of DUB?

A

Medical

  • progestogens
  • COCP
  • Danazol
  • GnRH
  • NSAIDs
  • Anti-fibrinolytics
  • capillary wall stabilisers

Progestogen-releasing IUCS
- mirena IUS

32
Q

What is the surgical management of DUB?

A

Endometrial resection/ablation

Hysterectomy

Reproductive & Sexual Health (54 decks)

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