Menstrual problems

Question 1

Kallman syndrome?

Answer 1

Congenital GnRH deficiency associated with anosmia

Question 2

Definition of secondary amenorrhoea?

Answer 2

3 months amenorrhoea in female who was previously menstruating

Question 3

How should young girls be investigated as an alternative to bimanual/speculum examination?

Answer 3

Transabdominal ultrasound

Question 4

Treatment for dysfunctional uterine bleeding? (4)

Answer 4

IUS first line
Tranexamic acid or mefanemic acid
COCP
Cycylical progestogen e.g. norithesterone day 5-26

Question 5

How long should trial of treatment with IUS for DUB continue for

Answer 5

6 months and assess response

Question 6

Symptoms suggestive of pathology other than DUB?

Answer 6

Persistent intermenstrual bleeding
Pelvic pain e.g. dyspareunia
Pressure symptoms

Question 7

What size of uterine fibroids would rule out IUS?

Answer 7

> 3cm

Question 8

Multiple reported symptoms that are relieved by menstruation?

Answer 8

Premenstrual syndrome

Question 9

Evidence-based non-drug interventions for premenstrual syndrome?

Answer 9

Exercise
CBT
Vitamin b6 supplements

Question 10

Medications for premenstrual syndrome? (3)

Answer 10

COCP containing drospirenone (e.g. Yasmin)
Continuous or luteal phase SSRIs
Spironolactone for bloating/breast tenderness

Question 11

Management of primary dysmenorrhoea? (2)

Answer 11

NSAIDs (e.g. mefanamic acid)

COCP/POP

Question 12

What does the development of secondary dysmenorrhoea suggest?

Answer 12

Underlying pathology