Menstrual Disorders Flashcards
Define Amenorrhoea
the absence of menstruation during the reproductive years of a woman’s life
Define Primary Amenorrhoea
the failure to establish menstruation by the time of the expected menarche
Define Secondary amenorrhoea
the cessation of menstruation in women with previous menses
Define Oligomenorrhoea
Irregular menses: < every 35 - 39 days
Primary Amenorrhoea Dx
- By 13 years when there is NO other evidence of pubertal development
- By 15 years of age where there are other signs of puberty, such as breast bud development
Secondary Amenorrhoea Dx
- A woman who has previously been menstruating misses three periods in a row (absence of menses for three cycles).
- A woman who has previously been menstruating does not have a period for 6 months or more.
Mayer–Rokitansky–Küster–Hause syndrome
underdevelopment of the reproductive system. There is usually a blind-ending vagina with an absent or underdeveloped uterus
Define Hypogonadism
lack of the sex hormones, oestrogen and testosterone
Hypogonadotropic hypogonadism
A deficiency of LH and FSH
Hypergonadotropic hypogonadism
A lack of response to LH and FSH by the gonads (the testes and ovaries)
Kallman Syndrome
- Anosmia
- Hypogonatropic hypogonadism
Hypergonadotropic Hypogonadism hormonal screen findings
- High LH/FSH
- Low oestrongen
Hypergonadotropic Hypogonadism causes
- Turner’s Syndrome
- Prev. ddamage to the gonads: torsion, cancers or infections e.g. mumps
- Congenital abscence of the ovaries
Hypogonadotropic Hypogonadism causes
- Hypopituitarism
- Hypothalamus/pituitary damage e.g. Sheehan syndrome, radiotherapy etc.
- Endo disorders: Cushing’s, Hypythyroid, hyperprolactinaemia (Prolactinoma)
- Kallman syndrome
Prolactinoma presentations
- Headaches
- Visual disturbances
- Galactorrhoea
Constituitional delay in menstruation presentations
- Secondary sexual characteristics
- Normal findings
Primary amenorrhoea examination
- BMI
- Development of secondary sexual characteristics
- ?Turner’s, ?Cushing’s, ?Prolacinoma, ?Kallman, ?PCOS
Premenstrual Syndrome
A condition characterized by cyclical and repetitive psychological, physical, and behavioural symptoms occurring in the luteal phase of the normal menstrual cycle that causes impairment of activities of daily living or affect quality of life
Premenstrual Sx
Physical Sx
- Abdo bloating
- Breast tenderness
- Headaches
- Minor mood changes
Premenstrual Syndrome Risk factors
- FMHx
- Caucasian female
- Postpubescent
- Pre-menopausal
- Smoking
- Early sexual abuse
- Domestic violence
PMS rare Sx
- Palpitations
- Hot flushes
PMS Dx
- Menstrual diary (Min. for 2 cycles)
- Sx only at the luteal phase
- Cyclical Sx only and relived by menstruation
- Sx affecting DALs/quality of life
- Timing of Sx
Premenstrual Dysphoric Disorder (PMDD) Dx
Mental condition
- Physical/Behavioural Sx documented for 1 year
- 5 or more Sx present a week prior to menses
- Sx resolving within days post menses
one behavioural / cognitive affective Sx
PMS Ix
- Hx taking
- Relevant examination
- Menstrual diary
- GAD 7 / PHQ 9
