Menstruation Flashcards
What hormone dominates follicular phase?
oestrogen
What hormone dominates luteal phase?
Progesterone
How long is the luteal phase?
Always 14 days
What does the inter-cycle rise in FSH during the follicular phase lead to?
follicle selection
What hormone does the dominant follicle produce
oestrogen
What hormone does the Corpus luteum produce?
Progesterone
What is menopause
the permanent. cessation of menstruation due to loss of ovarian follicular function.
when do you define menopause in someone above 50 years.
12 months after the last period
When do you define menopause in someone less than 50 years?
24 months after the last period
When is premature menopause defined as?
if the woman is younger than 40
What are the menopause symptoms such as change in length of menstrual cycles, dysfunctional uterine bleeding may occur and hot flushes etc. caused by?
falling oestrogen levels
What is primary amenorrhoea
failure to start menstruating by the age of 16. can be due to structural or genetic reasons.
What is secondary amenorrhoea
periods absent for more than 6 months other than due to pregnancy.
What is oligomenorrhea (infrequent periods) usually caused by? (3)
PCOS, premature menopause and hyperprolactinaemia
What is primary dysmenorrhea?
painful periods without organ pathology
What is secondary dysmenorrhea?
painful periods with associated pathology
What is the normal secondary hypothalamic causes of oligomernorrhea
low body fat / anorexia / excess excercise
How would you treat hyperprolactinaemia
Dopamine agonist (e.g. bromocryptine)
What are the congenital reasons for oligomenorrhoea
Turner’s syndrome (45XO) and disorders of sexual differentiation
What do you investigate in oligo-menorrhoea?
- exclude pregnancy with urinary or serum bhCG
- FSH + oestrodiol
- Prolactin, thyrdoi function tests
- Androgen levels (raised in PCOS)
- USS or vaginal and uterus for structural abnormalaties
What does low E2 with high FSH indicate
Ovarian problem
What does low E2 with low FSH indicate
pituitary or hypothalamic problem
When is menorrhagia defined as?
> 80 ml of blood loss
What are the most common causes of menorrhagia (2)
Dysfunctional uterine bleeding (DUB)
Anovulatory cycles
