Menstrual disorders Flashcards
Describe primary amenorrhoea. (1)
The failure to establish menstruation by 16.
Describe secondary amenorrhoea. (1)
Loss of a previously normal menstrual cycle for over 6 months.
Describe menorrhagia. Give some common causes and one common condition related to it. (3)
Excessive blood loss over consecutive cycles.
Contraceptions, warfarin, increased surface area (eg polyps), clotting disorders.
Often associated with anaemia.
Describe dysmenorrhoea.
Give common causes of primary and secondary. (3)
Pain during menses.
Primary - idiopathic, prostaglandin release related.
Secondary - endometriosis, PID, fibroids.
Define dysfunctional uterine bleeding. (1)
Heavy and irregular bleeding after anovulation (the settling).
Describe premenstrual syndrome. (3)
A subjective cyclical disorder occurring in the latter half of the menstrual cycle. Symptoms can be physical or psychological and resolve with menstruation.
Describe 4 common causes of menstrual disorders. (8)
Hormonal - HPO axis dysfunction.
Chromosomal abnormality - Turner’s syndrome, androgen insensitivity syndrome, congenital adrenal hyperplasia.
Structural - agenesis, imperforate hymen, adhesions.
Medical - chronic illness, bleeding disorders, being underweight, thyroid disease, drugs.
Describe the correct form for a consultation regarding menstruation. (4)
History - age, menarche, menstrual history, sexual history.
Examination - abdominal, specula.
Investigations - hormone profile, karyotype, thyroid function tests, hysteroscopy.
Management - pharmacological, surgical.
Describe PCOS. (8)
Pathophysiology
Presentations
Polycystic Ovarian Syndrome.
Hyperandrogenism and chronic anovulation due to no pulsatile GnRH, meaning many follicles begin to develop (and begin to release oestrogen) but none are selected, leading to lots of oestrogen, which causes constant LH surge.
Patients present with secondary amenorrhoea, infertility, hirsuitism, obesity, endometrial malignancy, DM and CVD due to androgen encouraged insulin resistance.
