Menstrual Problems

Question 1

For most women, a normal menstrual cycle ranges from …

Answer 1

21 to 35 days.

Question 2

Normal cycle starts when …

Answer 2

Pituitary Follicle-Stimulating Hormone induce ovarian follicles to produce estrogen.

Question 3

Estrogen stimulates proliferation of the …

Answer 3

Endometrium.

Question 4

A Luteinizing Hormone surge Prompts …

Answer 4

Ovulation.

Question 5

The resultant Corpus Luteum produces …

Answer 5

Progesterone.

Question 6

The production of progesterone produced at Corpus Luteum induces …

Answer 6

A secretory endometrium.

Question 7

In the absence of pregnancy, estrogen and progesterone levels decline inducing …

Answer 7

withdrawal bleeding occurs 13 to 15 days post-ovulation.

Question 8

Menstrual Irregularities

Answer 8

Are changes to the menstrual cycle that result in missed periods, irregular periods, or excessive bleeding.

Question 9

Menstrual Irregularities can be caused by …

Answer 9

Pregnancy;
Hormonal imbalances;
Infections;
Maligancies;
Diseases;
Trauma;
Certain medications.

Question 10

The key characteristic of abnormal uterine bleeding are …

Answer 10

Regularity;
Frequency;
Heaviness of flow;
Duration of flow;

Question 11

Abdormal uterine bleeding that occurs from adolescence through perimenopause can be broadly divided into two categories:

Answer 11

anovulatory and ovulatory.

Question 12

Anovulatory bleeding

Answer 12

Is characterized by irregular or infrequent periods, with flow ranging light to excessively heavy.

Question 13

Terms commonly associated with anovulatory bleeding include:

Answer 13

Amenorrhea;

Oligomenorrhea.

Question 14

Amenorrhea

Answer 14

Absence of periods for more than three cycles.

Question 15

Oligomenorrhea

Answer 15

Menses occurring at intervals of more than 35 days.

Question 16

Causes of anovulatory bleeding include …

Answer 16

Adolescence;
Uncontrolled diabetes;
Eating disorders;
Hyperprolactinemia;
Hyperthyroidism or Hypothyroidism;
Medications (Such as antiepileptics or antipsychotics);
Perimenopause;
Polycystic Ovary Syndrome (PCOS);
Pregnancy.

Question 17

Ovulatory Bleeding

Answer 17

Occurs at normal, regular intervals but that is excessive in volume or duration.

Question 18

Causes of ovulatory abnormal uterine bleeding include…

Answer 18

• Structural problems (such as uterine fibroids or polyps);
• Bleeding disorders (such as leukemia, platelet disorders, factor deficiency, or Von Willdebrand disease);
• Hypothyroidism;
• Advanced liver disease;

Question 19

What are the additional causes of menstrual irregularity?

Answer 19

• Endometriosis;
• Endocrine Gland-Related causes (Cushing’s Syndrome; Primary Ovarian Insufficiency; Late-Onset Congenital Adrenal Hyperplasia);
• Acquired Conditions (Stress-related Hypothalamic Dysfunction; Exercise-induced amenorrhea);
• Tumors (Ovarian; Adrenal; Prolactinoma);

Question 20

What are other menstrual irregularities?

Answer 20

• Polymenorrhea;
• Irregular menstrual periods with a cycle-to-cycle variation of more than 20 days;
• Shortened menstrual bleeding of less than 2 days in duration;
• Intermenstrual Bleeding.

Question 21

Polymenorrhea

Answer 21

Frequent menstrual periods occuring less than 21 days apart.

Question 22

Intermenstrual Bleeding

Answer 22

Episodes of bleeding that occur between periods, also known as spotting.

Question 23

Can menstrual irregularities make it harder to get pregnant?

Answer 23

Some of the causes can make it harder to get pregnant, including:

• Polycystic Ovary Syndrome (PCOS);
• Endometriosis;
• Primary Ovarian Insufficiency (POI);
• Uterine Fibroids;

Question 24

Can menstrual irregularities lead to cancer?

Answer 24

• Recurrent anovulation causes an increased risk of endometrial cancer.
• About 14% of premenopausal women with recurrent anovulatory cycles develop endometrial cancer or its percursor, hyperplasia with atypia.
• In Contrast, women with ovulatory bleeding produce progesterone, slough the endometrium regularly, and have minimal risk of developing cancer.