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Women's Health EOR > Menstruation > Flashcards

Menstruation Flashcards

1
Q

Primary amenorrhea

A

Failure to begin menstruating

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2
Q

Secondary amenorrhea

A

Absence of menses for 6 months in a previously menstruating patient

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3
Q

Etiology of primary amenorrhea

A

Ovarian insufficiency due to genetics

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4
Q

Etiology of secondary amenorrhea

A

Pregnancy
PCOS
Pituitary disease

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5
Q

Sheehan’s syndrome

A

Postpartum pituitary necrosis

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6
Q

Mullerian dysgenesis

A

Congenital absence of uterus and upper 2/3 of vagina

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7
Q

Asherman’s syndrome

A

Uterine adhesions

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8
Q

Primary amenorrhea with low FSH and LH

A

Issue with the HPO axis
- Get an MRI

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9
Q

Primary amenorrhea with high FSH

A

Ovarian failure
- Check karyotype for genetic issues

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10
Q

Treatment of amenorrhea if desiring pregnancy

A

Ovulation induction with Clomid or Letrozole

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11
Q

Treatment of amenorrhea if not desiring pregnancy

A

Estrogen/progesterone

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12
Q

Dysmenorrhea

A

Painful menstruation

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13
Q

Treatment of dysmenorrhea

A

NSAIDs
Hormonal contraceptives

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14
Q

S/S of PMS and PMDD

A

HA
Fatigue
Breast tenderness
Bloating
Abdominal pain
Mood swings
Irritability

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15
Q

PMS vs PMDD

A

PMDD: clear functional impairment with predominant psych symptoms

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16
Q

Treatment of PMS/PMDD

A

Mild: behavioral modifications and symptomatic tx
Severe: SSRIs and OCPs

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17
Q

Menorrhagia

A

Heavy bleeding

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18
Q

Hypomenorrhea

A

Light bleeding

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19
Q

Metrorrhagia

A

Bleeding between normal menses

20
Q

Polymenorrhea

A

Menses occurring too frequently

21
Q

Menometrorrhagia

A

Bleeding with irregular intervals and amount

22
Q

Oligomenorrhea

A

Menses occurring too infrequently

23
Q

Evaluation of dysfunctional uterine bleeding (DUB)

A

Pelvic US
Endometrial biopsy
Hysteroscopy

24
Q

Treatment of premenopausal DUB

A

Observation
Hormone therapy

25
Q

Treatment of postmenopausal DUB

A

Hormones
US
Hysteroscopy

26
Q

Menopause

A

No period for 12 months

27
Q

Hormone levels in menopause

A

Low inhibin
Increased FSH and LH
Decreased estrogen
Decreased progesterone

28
Q

S/S of menopause

A

Hot flashes
Mood swings
Vaginal dryness
Hair loss

29
Q

Treatment of menopause

A

Vaginal moisturizer
Estrogens

30
Q

Known risks of hormone replacement

A

Endometrial cancer
Breast cancer
Clots

31
Q

1st line tx for vasomotor menopause sx

A

Transdermal hormones

32
Q

Pros and cons of combination hormone therapy

A

Pro: adding progesterone to estrogen decreases risk of endometrial cancer rather than just unopposed estrogen
Con: addition of progesterone to estrogen increases risk of breast cancer

33
Q

If patient has intact uterus ___

A

Must do combo estrogen and progesterone

34
Q

Actions of estrogen

A

Endometrial proliferation
Development of secondary sex characteristics
Increased vaginal lubrication

35
Q

Actions of progesterone

A

Decrease uterine contractility
Promotes breast development
Falling levels trigger menses and lactation

36
Q

Major hormone of pregnancy

A

Progesterone

37
Q

What hormone leads to ovulation

A

LH surge/peak

38
Q

Mittelschmerz

A

Mid-cycle pain

39
Q

Pre-ovulatory phase of ovarian cycle

A

Varying length
Several follicles enlarge until one becomes dominant and grows rapidly and the others regress

40
Q

Mid-ovarian cycle

A

Mature follicle ruptures

41
Q

Post-ovulatory phase of ovarian cycle

A

Always 14 days
Corpus luteum makes progesterone and estrogen
If pregnancy does not occur, LH and FSH decline and corpus luteum atrophies
Decreased progesterone leads to shedding of uterine lining

42
Q

Why does progesterone trigger menses?

A

Progesterone controls blood supply to endometrium, so when it drops, the endometrium sheds

43
Q

Days 1-5 of uterine cycle

A

Menstrual phase

44
Q

Proliferative phase of uterine cycle

A

Estrogen rises causing endometrium to regenerate
Uterine glands lengthen

45
Q

Secretory phase of uterine cycle

A

Progesterone causes endometrium to mature
Corpus luteum regresses leading to decreased estrogen and progesterone

46
Q

Hormone effect on cervical mucus

A

Estrogen: thins and creates fern-like pattern
Progesterone: thickens

47
Q

When is cervical mucus thinnest and thickest?

A

Thinnest: ovulation
Thickest: following ovulation and pregnancy

Women's Health EOR (11 decks)

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