Menstrual Disorders Flashcards
What are some causes of amenorrhea?
- anorexia, weight loss
2. no known cause
Dx for amenorrhea?
3 missed cycles or
6 months of no bleeding in a previously menstruating women
How can you tx a amenorrhea in anorexia?
correct weight or decrease exrecise
or
use estrogen replacement -higher dose
conjugated estrogen ( not a contraceptive dose)
ethinyl estradiol patch ( not contraceptive dose)
How can you tx menstrual irregularity of unknown cause?
progestrone challenge: withdrawal bleed 7 days after the last dose, HPA axis is intact but issue probability with anovulation and lack of progestrone
What is menorrhagia?metorrhagia? polymenorrhea?
heavy bleeding
girl is ovulating, abnormal uterine bleeding
metorrhagia: bleeding within cycle
polymenorrhea: cycle less than 21 days
What is tx for menorrhagia?
If women does want to have kids: use NSAID —>tranexamic acid–>luteal phase progestrone–> HC or LNG-IUS
or
LNG IUS—> OC–>endometrial ablation surgery
What are some complications fro HBMB?
vWF
low platelets/dysfunction
hypothyrodism
What is the clinical use of tranexamic acid
use when HC not a choice
MOA of tranexamic acid?
reverisbly blocks lysine site on plaminogen and
ADE of TA?
N/V/D
What is MCC of AUB-O?
PCOS
LH:FSH >2, followed by DHEA or testoterone=PCOS
LH and FSH high with hoit flashes = menopause
How do you tx anoculation from PCOS?
weight loss
clomiphene citrate
metformin
if they dont want to have kids:
-use weight loss, metformin, OC with progestrone and reduced androgenetic effects
drusg for tx PCOS?
MPA-depo
Comination OC: drospirenone
Metformin?
reduces insulin resistance
ADE: anorexia, N/V/D,
Monitor for ovualtion after 3-6 mo of therapy
What is dysmenorrhea?
painful menstruation
