Menstrual Suppression

Question 1

Choose all of the following which are considered acceptable indications for menstrual suppression:

a) social choice
b) endometriosis
c) AUB
d) PMDD
e) pubertal developmental delay

Answer 1

all but e) -SOGC recommends against menstrual suppression until the patient is post-menarche so that you can confirm normal function

Question 2

Choose the true answers:

a) The use of anti-epileptic drugs may make OCPs less effective
b) The use of feeding tubes may make OCPs less effective
c) the mini-pill has lower rates of amenorrhea compared to OCP
d) Patients on DMPA should be counselled re: rates of decreased bone mineral density and should be on Ca and Vit D

Answer 2

a) no evidence but may require higher doses to suppress menses CYP450
b) true -may require higher doses -consider patch/ring
c) true
d) true -reversible BMD loss

Question 3

What is the mechanism of action of the mirena IUS?

Answer 3

1. thickened cervical mucous
2. inhibited endometrial proliferation
3. impaired sperm mobility

Question 4

Which is false regarding menstrual suppression in cancer patients?

a) suppression is aimed at decreasing the rate of thrombocytopenia
b) treatment should be initiated one month prior to starting chemo
c) lupron is the drug of choice for menstrual suppression
d) OCP is contra-indicated due to the increased VTE risk in this population

Answer 4

d