menstrual related disorders

Question 1

what is the MC cause of amenorrhea?

Answer 1

unrecognized pregnancy

Question 2

what is anovulatory bleeding?

Answer 2

bleeding from the uterine endometrium as a result of dysfx’ing menstrual bleeidng

Question 3

what are some causes for amenorrhea?

Answer 3

PREGNANCY
anorexia/excessive exercise
hyperprolactinemia
anovulation 2/2 PCOS

Question 4

tx for primary or secondary amenorrhea?

Answer 4

CEE, ethinyl estradiol patch, combo OC

Question 5

what is the 1st line progesterone for secondary amenorrhea?

Answer 5

Micronized progesterone

Question 6

ADE’s for dopamine agonists?

Answer 6

Hypotension, N, constipation, anorexia, Raynaud’s phenomenon, fatigue, HA

Question 7

ADE’s for combo OC’s/CEE’s?

Answer 7

Thromboembolism, breast enlargement & tenderness, bloating, N, GI upset,
HA, peripheral edema

Question 8

ADE’s for MPA (oral and injectable?

Answer 8

Edema,
anorexia, depression, insomnia,
wt gain/loss, increase in serum total and LDL cholesterol,
may reduce HDL cholesterol

Question 9

what is the pharmacologic tx for dysmenorrhea?

Answer 9

1st line = monthly NSAID’s beginning at time of onset of sxs.

2nd line = hormonal contraceptives for a 2-3 cycles

3rd line = MPA or depo

Question 10

tx for menorrhagia?

Answer 10

NSAIDs during menses

LNG-IUS (mirena)

Question 11

MOA of tranexamic acid?

Answer 11

Antifibrinolytic effects by reversibly blocking lysine binding sites on plasminogen–> preventing fibrin degradation and a reduction in menstrual blood loss

Question 12

ADE’s of tranexamic acid?

Answer 12

N/V/D, dyspepsia

Question 13

how soon will you see improvement in tranexamic acid?

Answer 13

reduction in blood loss w/menses noticeable w/in 1st mo

Hgb/hematocrit after 3 mo compared to baseline

Question 14

tx for PCOS-related amenorrhea and/or AUB-O

Answer 14

injectable MPA, combo OC

Oral MPA

Metformin

Question 15

Metformin ADE’s

Answer 15

Anorexia, N/V/D, flatulence, lactic acidosis (rare)

Question 16

what is important to remember with imaging if a pt is on Metformin?

Answer 16

have to stop 1 day prior if giving IV contrast (restart when renal fx is normal)

Question 17

what are some pharmacologic tx options for PMDD?

Answer 17

clomipramine
drospirenone
leuprolide
SSRI's
SNRI's

Question 18

in what phase of the menstrual cycle can you give medications for PMDD?

Answer 18

luteal phase

Question 19

ADE’s for clompramine?

Answer 19

dry mouth, constipation, fatigue, vertigo, sweating

Question 20

ADE’s for leuprolide (GnRH agent)?

Answer 20

hot flashes, night sweats, HA’s, N

Question 21

ADE’s for SSRI’s?

Answer 21

sexual dysfx, insomnia, sedation, hypersomnia, N/D