Menstrual Disorders Flashcards
Menorrhagia
xs flow (>80cc) or >7 days
Metororrhagia
irregular intervals
AUB classification for abnormal uterine bleeding
PALM COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy and Hyperplasis
Coagulopathy
Ovulatory dysfxn
Endometrial
Iatrogenic
Hypothalamic causes of AUB
Functional hypothalamic suppression
(hypOthalamic hypOgonadism)
via stress, diet, exercise, idiopathic
hyperthyroidism
amenorrhea
hypOthyroidism
menorrhagia
congenital GnRH deficiency
Kallmann syndrome
- anosmia
- delayed/absent puberty
- due to failure of GnRH neurons to develop and migrate
most common pituitary tumor
prolactinoma
galactorrhea, HA, amenorrhea/oligomenorrhea
prolactin suppresses ___ secretion
GnRH
DA agonists
bromocriptine, cabergoline
Sheehan’s syndrome
ischemia and infarction of pituitary
GnRH blocked
PCOS
- anovulation
- hirsutism and/or acne
- arrested follicle development
- insulin resistance
arrested follicle development
secondary follicles that do not mature properly in the hyperandrogenic environment (no dominant follicle forms)
string of pearls
polycystic ovaries
dx criteria for PCOS
Rotterdam Criteria
- hyperandrogenism
- ovulatory dysfunction
- polycystic ovaries on US
need 2/3
PCOS tx
weight loss/exercise hormonal tx metformin androgen receptor blockers 5-alpha-reductase inhibitors ovulation induction
spironolactone
flutamide
androgen receptor blockers
finasteride
5-alpha-reductase inhibitors
FSH levels in Turner syndrome
high bc pituitary is trying to encourage ovaries to make more estrogen and there is lack of negative feedback because estrogen levels are low (likely has streak gonads)
endometriosis dx
peritoneal biopsy = endometrial stroma and glands, even in absence of lesions
chocolate cyst
endometriosis
hemosiderin derived from previous intra-ovarian hemorrhage
tx for difficult to treat endometriosis
GnRH agonists (medically induce menopause; stimulate gonadotropin release and eventually cause a down-regulation of GnRH receptors)
Surgery (adhesiolysis, fulguration, resection, hysterectomy)
