Menstrual Disorders Flashcards
Describe the characteristics of primary dysmenorrhea
It is your typical cramping. It generally occurs within 6 months of first period. It resolves within 48 to 72 hours
Describe the characteristics of secondary dysmenorrhea
Onset is 20 and 30’s. Accompanied by heavy bleeding, irregular menses, vaginal discharge, infertility, and painful sex(dyspareunia). It is usually not responsive to NSAIDs or oral contraceptives
What are the non pharmacological treatment for Dysmenorrhea
Acupuncture. Heat pad. Omega 3 fatty acids and vitamin D. Aerobic exercise Smoking cessation
Is mefenamic acid an NSAID used to treat dysmenorrhea yes or no
Yes it is at high doses
List the pharmacological treatments for dysmenorrhea
NSAIDS, leuprolide acetate, Danazol, oral contraceptives
What are the characteristics of primary amenorrhea
No menses by age 14 with absence of sings of puberty and no menses by age 16 with other signs of puberty
What are the characteristics of secondary amenorrhea
No menses for 3 months with previously regular period and no menses for 6 months with previously irregular periods
What is menorrhagia
Heavy bleeding when the bleeding is more than 80 ml a day
What is polymenorrhea
When the menstrual cycle is too short like less than 21 days
What is oligomenorrhea
When the cycle is too long. When it is more than 35 days
What is amenorrhea
Not having periods for 6 months it more
What is dysmenorrhea
Painful periods or cramping
What are the treatment options for acute menorrhagia
Tranexamic acid, medroxyprgesterone, and high dose estrogen
What is metrorrhagia
Bleeding between periods
Mention the two selective progesterone modulators used for fibroids
Ullipristal acetate and mifepristone
What are the criteria to diagnose a person with PMS
Must have at least 1 or more symptoms. It must be affecting their work life balance, must occur within 5 days before menses, must occur in 3 consecutive cycles
What are the criteria to diagnose PMDD
Must have 5 or more symptoms, must be significantly distressed with daily life, must occur 7 days before menses and resolve within a few days after starting menses, must occur in at least 2 symptomatic cycles
How long can you take ullipristal acetate for before fibroid surgery
Up to a year and it has less hypo androgenic problems
How long can you take GNRH agonists for
6 months before surgery
What is the first line treatment for PMS, PMDD
SSRI, NSAIDs, and spironolactone
What are the SSRI approved for PMDD
Sertraline, paroxetine, and fluoxetine
What is the black box warning for SSRI
Increased suicidal thinking in children and young adults with depression and other psychiatric disorders
What are the medications for sexual interest/arousal disorders
Addyi(finanserin) and vyleesi(bremalanotide)
What are the counter indications for Addyi
Wait 2 hours if you have taken 1 or 2 drinks of EtOH. Skip dose if more than 3 drinks. Should not be used by people with hepatic impairment or used with strong CYP3A4 inhibitors
What are the counter indications for VYLEESI(brelanotide)
Given at least 45 minutes before sex. Counter indicated in people with uncontrolled hypertension
What are the drugs for dyspareunia
Ospemifene
What are the counter indications for ospemifene
Previous venous thromboembolism and estrogen sensitive cancer like breast cancer or endometrial cancer
