menstrual disorders Flashcards
what is secondary amenorrhea
- in a woman who has previously menstruated, absence of menses for 3 months
- in a women with irregular menses, it is 6 months absence of menses
what is primary amenorrhea with and w/out secondary sex characteristics
with: absence menstruation by age 16
w/o: absence menstruation by age 14
common cause of primary amenorrhea
pregnancy
women who fail to menstruate in the presence of estrogren stimuation of the endometrium…
are at increased risk for endometrial cancer
drug use, stress, big wt change, excessive exercise
think secondary amenorrhea
cause of secondary amenorrhea in a woman with nml estrogen
asherman syndrome(intrauterine synechiae) or PCOS
first line test for amenorrhea
B-hCG, TSH, prolactin
CNS tumor, stress, hyperprolactinemia, hypophysitis, sheenan syndrome, premature ovarian syndrome
causes of secondary amenorrhea in a hypoestrogenic women
what test to do determine the presence or absence of sufficient estrogen
progesterone challenge test
streak gonads, shield chest, amenorrhea, webbed neck, aortic coartatation, bicuspid aortic valve
turner syndrome
increased prolactin means what
inhibits the release of GnRH and thus LH and FSH; points to a pituitary pathology
etiology of hypogonadotrophic hypogonadism
hypothalmic or pituitary problem
etiology of hypergonadotrophic hypogonadism
ovaries have failed to produce estrogen
primary dysmenorrhea
- caused by what
- occurs when
- painful menstruation with no pathologic abnormality
- excess prostaglandin and leukotriene levels
- occurs within 2 years of menarche
primary dysmenorrhea symptoms
painful contractions/cramping in lower abdomen or pelvis radiating to back/thighs, n/v, diarrhea
primary dysmenorrhea tx
NSAIDs, heat, combined OCPs, progestin IUD
secondary dysmenorrhea causes; age
endometriosis, adenomysis, fibroids, adhesions, IUD, PID;
over 25 yrs of age
when does primary and secondary dysmenorrhea peak
primary: late teens and early 20s
secondary: incidence increases with age
secondary dysmenorrhea symptoms
similar to primary but also bloating, menorrhagia, dysparenunia
primary and secondary dysmenorrhea related to flow
primary: begins or at onset of menses and lasts 1-3 days
secondary: less related to first day of flow
primary dysmenorrhea
- breast development
- pubic and axillary hair
yes to breast development
no pubic or axillary hair
imperforate hymen
a completely sealed hymen will prevent menstrual flow
gonadal agenesis or dysgenesis
hypoplastic dysfunctional ovaries
turner syndrome
45, X
