Menstruation Flashcards
1
Q
What is pms?
A
-pre-menstrual syndrome
2
Q
What must PMS be differentiated from?
A
- physiological menstrual symptoms
3
Q
Symptoms of PMS?
A
- Depression
- Anxiety
- mood swings
- bloating
- food cravings
4
Q
When is PMS present?
A
- days immediately before menstruation
- luteal phase
5
Q
Other variants of menstrual symptoms that don’t meet PMS criteria?
A
- premenstrual exacerbation of underlying disorder
- non-ovulatory PMD
- Progesterone induced PMD
- PMD with absent menstruation
- pre-menstrual dysphoric disorder
6
Q
Diagnosis of PMS?
A
- Diary symptom tracker over 2 cycles
- GnRH analogus
7
Q
Causes of PMS?
A
- Sensitivity to progesterone
- serotonin receptors
- less allopregnalone
8
Q
1st line treatment of pMS?
A
- Exercise, CBT, Vitamin b6
- New generation COCP
- Low dose ssri
9
Q
2nd line treatment of PMS?
A
- High dose SSRI
- Estrogen + progesterone patch
10
Q
Why is low dose progesterone given in treatment of PMS with hormonal therapy?
A
- complete opposition of progesterone, can cause endometrial dysplasia -> cancer
- lowest possible dose progesterone given as protection
11
Q
3rd line treatment of PMS?
A
- GnRH analogue
12
Q
4TH Line treatment of PMS?
A
- Surgical management + hRT
13
Q
Name a GnRH inhibitor? and what must be co-prescribed
A
- danazol
- suitable contraception as can cause virilising
14
Q
GnRH analogues may cause?
A
- reduced bone mass
- should be used in unclear diagnosis of PMS
- Long term use not usually advised, but if so, HRT co-prescrbied
15
Q
Surgical management of PMS?
A
- When medical management failed
- trial of GnRH analogue before had
- hysterectomy + BSO
