Menstrual Disorders Flashcards
What is the average age range from menarche to menopause?
13-51
How is the range in length of a menstrual cycle?
21-35 days
What is the mean blood loss during menstruation?
30-40ml
Why does menstruation occur?
Triggered by a fall in progesterone 2 weeks after ovulation if not pregnant
What is menorrhagia?
Heavy periods (>80ml/cycle)
What is dysmenorroea?
Painful menstruation
What is oligomenorrhoea?
Infrequent periods
What investigations should be considered for menstrual problems?
FBC if menorrhagia Endometrial biopsy Chalmydia test Thyroid function tests Coagulation tests Pregnancy test TV USS Hysteroscopy Laparoscopy
What are the likely causes of menstrual problems in early teens?
Anovulatory cycles
Congenital anomaly
Coagulation problems
What are the likely causes of menstrual problems in teens - 40?
Chlamydia Contraception related Endometriosis/ adenomyosis Fibroids Endometrial or cervical polyps Dysfunctional bleeding
What are the likely causes of menstrual problems from 40 - menopause?
Perimenopausal anovulation
Endometrial cancer
Warfarin
Thyroid dysfunction
What is dysfunctional uterine bleeding?
Abnormal bleeding but no structural/ endocrine/ neoplastic/ infectious cause found
What is endometriosis?
Endometrial type tissue outside the uterine cavity
What are the symptoms of endometriosis?
Premenstrual pain
Dysmenorrhoea
Deep dyspareunia
Subfertility
What are the signs of endometriosis?
Tender nodules in rectovaginal septum
Limited uterine mobility
Adnexal mass
Asymptomatic
How is endometriosis diagnosed?
Laparoscopy
MRI
USS endometrioma
What are the common areas to find endometriosis?
Ovary
Pouch of Douglas
Pelvic peritoneum
What are the treatment options for endometriosis?
Progesterone (oral/inject/mirena ius)
Combined pill 3 months at a time
GnRH analogues
Surgical (excision/ diathermy/laser ablation/ hysterectomy/ oophorectomy)
What is adenomyosis?
Endometrial tissue found deep in myometrium
What are the symptoms and signs of adenomyosis?
Heavy painful periods
Bulky tender uterus
How is a diagnosis of adenomyosis made?
USS
Laparoscopy
Hysteroscopy
What are the treatment options for adenomyosis?
Mirena
What are fibroids?
Smooth muscle growths leiomyoma
How is a diagnosis of fibroids made?
Clinical exam
USS
Hysteroscopy
What are the different types of fibroids?
Submucous (protrude into uterine cavity) Intramural (within uterine wall) Sub serous (project out of uterus into peritoneal cavity)
What are the symptoms of fibroids?
Pressure symptoms
Menorrhagia
Intermenstrual bleeding
Pain
What are the treatment options for fibroids?
GnRH analogues Ulipristal oral antiprogesterone Transcervical resection sub mucous fibroids Uterine artery embolisation Hysterectomy
What are some fertility conserving treatments fro DUB menstrual problems?
Tranexamic acid Mefanamic acid Combined pill Mirena Oral progesterone
What are the treatments used for DUB menstrual disorders if family is complete?
Endometrial ablation
Hysterectomy
