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Reproductive system > Menstrual disorders > Flashcards

Menstrual disorders Flashcards

1
Q

What is the menstrual cycle?

A

The time from the first day of a woman’s period to the day before her next period

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2
Q

What is normal blood loss from menstruation?

A

Less than 80mls over 7 days

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3
Q

What is the average duration of menstruation?

A

2-7 days

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4
Q

What is the average length of the cycle?

A

24-35 days

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5
Q

When is menarche normal?

A

10-16 years

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6
Q

When is normal for menopause?

A

50-55years

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7
Q

What are the 4 categories of disturbance of menstruation?

A

Disturbance of frequency
Irregularity
Abnormal duration of flow
Abnormal menstrual volume

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8
Q

How can heavy menstrual bleeding be quantified?

A

Bleeding >7days
Need to change menstrual products every 1-2 hours
Passage of clots greater than 2.5cm
Bleeding through clothes
Heavy periods as reported by patient impeding on QoL

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9
Q

What is the main health implication of heavy menstrual bleeding?

A

Anaemia

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10
Q

What are causes of heavy menstrual bleeding?

A 
Fibroids
Endometrial polyps
Endometriosis
PID
PCOS
Coagulation disorders
Hypothyroidism
Liver/renal disease
Anticoagulant treatment
Herbal supplements
IUD
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11
Q

What are fibroids?

A

Non-cancerous growths made of muscle and fibrous tissue, also called lieomyoma

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12
Q

What are symptoms of fibroids?

A 
May be asymptomatic
Heavy menstrual bleeding
Pelvic pain
Urinary symptoms
Pressure symptoms
Backache
Infertility
Miscarriage
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13
Q

How are fibroids diagnosed?

A

Ultrasound scan

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14
Q

How are fibroids managed if medical treatment is declined or failed and fertility preservation is not required?

A

Hysterectomy

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15
Q

What is endometriosis?

A

Endometrial tissue outside the lining of the uterus

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16
Q

Why does endometriosis cause heavy menstrual bleeding?

A

The tissue behaves like Endometrium and bleeds

17
Q

What are symptoms of endometriosis?

A 
Pelvic pain
Heavy menstrual bleeding
Infertility
Fatigue
Systemic symptoms
18
Q

How is endometriosis diagnosed?

A

Pelvic examination
Ultrasound scan
Diagnostic laparoscopy

19
Q

How is endometriosis managed?

A

Analgesia
Medical - COCP, POP, Mirena IUS
Surgical - ablation, hysterectomy, endometrioma excision

20
Q

What is adenomyosis?

A

A condition where the endometrium becomes embedded in the myometrium

21
Q

What are symptoms of adenomyosis?

A

Heavy menstrual bleed

May have significant dysmenorrhoea

22
Q

How is adenomyosis treated?

A

Hysterectomy

23
Q

What are endometrial polyps?

A

Overgrowth of endometrial lining which extend into endometrium

24
Q

How are endometrial polyps diagnosed?

A

Ultrasound or hysteroscopy

25
Q

How are endometrial polyps managed?

A

Polypectomy

26
Q

What medications can be given for heavy menstrual bleeding?

A 
Tranexamic acid
Mefanamic acid
Hormonal contraception
Combined contraceptive pill
Oral progesterones
27
Q

What is salpingo-oophectomy?

A

Removal of tubes and ovaries

28
Q

What is the main disadvantage of salpingo-oophectomy?

A

Immediate menopause - HRT is recommended until age 50

29
Q

What are advantages of salpingo-oophectomy?

A

Reduce risk of subsequent ovarian cancer

30
Q

What is oligomenorrhoea?

A

Infrequent or abnormally light menstruation

31
Q

What is amenorrhoea?

A

Absent menstruation

32
Q

What life changes can cause oligo/amenorrhoea?

A 
Stress
Eating disorders
Malnourishment
Obesity
Intense exercise
33
Q

What are other causes of oligo/amenorrhoea outside of lifestyle changes?

A 
Hormonal problems 
Primary ovarian sufficency
PCOS
Hyperprolactinaemia
Prolactinomas
Thyroid disorders
Obstructions of the uterus
34
Q

What is used to diagnose PCOS?

A

USS appearance of ovary
Biochemical hyperandrogenism
Clinical hyperandrogenism
Diagnosed if 2 of 3 criteria met

35
Q

What is PCOS associated with clinically?

A

Infertility
Oligo/amenorrhoea
Increased risk with obesity

36
Q

What is the main management for PCOS?

A

Lifestyle management to achieve normal BMI

37
Q

Why are bleeds required in PCOS?

A

Prevents hyperplasia - 3 bleeds per year required

38
Q

What is dysfunctional uterine bleeding?

A

Excessive uterine bleeding affecting premenopausal women that is not due to pregnancy or any recognisabe uterine or systemic disease

Reproductive system (26 decks)

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