Menstrual Disorders Flashcards
1
Q
what is the normal amount of blood lost during menstruation?
A
- less than 80ml over 7 days (16 tsp)
- average loss: 30-40ml (6-8tsp)
2
Q
list the potential causes of heavy menstrual bleeding
A
- uterine fibroids
- endometrial polyps
- endometriosis and adenomyosis
- PID and infection
- endometrial hyperplasia or carcinoma
- PCOS
- coagulation disorders
- hypothyroidism
- liver or renal disease
- anticoagulant treatment
- herbal supplements (gingseng, ginkgo, soya)
- IUD
3
Q
what are uterine fibroids?
A
- non-cancerous growths made of muscle and fibrous tissue, also called myoma or lieomyoma
4
Q
uterine fibroids symptoms
A
- HMB
- pelvic pain
- urinary symptoms
- pressure symptoms
- backache
- infertility
- miscarriage
5
Q
uterine fibroids diagnosis imaging
A
US
6
Q
uterine fibroids levels of treatment
A
- for HMB +/- small fibroids > COCP, POP, Mirena
- large fibroids and fertility preservation desired > fibroid embolisation, myomectomy
- submucosal fibroids > hysteroscopic fibroid resection
- declined or failed medical treatment & fertility preservation not required > hysterectomy
7
Q
endometriosis definition
A
Defined as endometrial tissue present outside the lining of uterus .During menstruation this ectopic tissue behaves the same as endometrium and bleeds
8
Q
endometriosis symptoms
A
- may present with HMB
- painful menstrual cramps that worsen over time
- pain during and after intercourse
- lower back pain
- painful bowel movements or urination
- abnormal bleeding ot spotting between menstrual periods
- infertility
- fatigue
- diarrhoea, nausea, bloating
9
Q
what are the four stages of endometriosis?
A
- stage 1, minimal: mall patches, surface lesions or inflammation on or around organs in pelvic cavity
- stage 2, mild: more widespread and starting to infiltrate pelvic organs
- stage 3, moderate: peritoneum or other structures, sometimes also scarring and adhesions
- stage 4, severe: infiltrative and affecting many pelvic organs and ovaries, often with distortion of the anatomy and adhesions
10
Q
endometriosis diagnostic investigations
A
- pelvic exam
- US, diagnostic laparoscopy
11
Q
endometriosis management options
A
- analgesia]
- medical: COCP, POP, Mirena IUS, depot provera, GnRH analogues
- ## surgical: ablation, hysterectomy endometrioma excision, pelvic clearance, hysterectomy
12
Q
describe uterine adenomyosis
A
- a condition where endometrium becomes embedded in myometrium
13
Q
adenomyosis symptoms
A
- HMB
- may have dysmenorrhea
14
Q
adenomyosis treatment
A
- may respond to hormones partially
- definitive treatment is hysterectomy
15
Q
describe endometrial polyps
A
- overgrowth of endometrial lining can lead to formation of pediculated structures called polyps which extend into endometrium
- mostly benign
