Menstruation and disorders of menstruation Flashcards
Normal menstruation depends on normal function of
Hypothallamus
Pitiutary gland
ovaries
uterus
What is the menstrual cycle
Series of regular cyclical changes in ovaries and uterus experienced by non pregnant women in their reproductive years from onset of menses to cessation of menses.
Mernache is
onset of menses
common mode or cycle in reproductive ages
28 day cycle
Day of ovulation in cycle
14th day
Irregular cycles occur
2 years after menarche
3 years after menopause
Mean age for menarche and menopause
12 and 48 respectively
Number of ovaries in fetus at 16-20 wks of pregnancy
6-7 million declining to 2 million at birth and 300,000,-500000 at puberty.
About 500 used for ovulation, the rest undergo degeneration
Beginning of onset of action FSH and LH
9-12 years leading to activation of ovaries which produce estrogen and progesterone and menstrual cycle begins
FSH and LH are what molecules
glycoproteins
Ovarian cycle involves
All events from the development of primordial follicle to the formation of corpus albicans
Stages of follicular development
Primordial- primary secondary tertiary graafian
Primordial follicle is
The ovum in the child at birth
Primary follicle
First stage of follicular growth where immature ovarian follicle is surrounded by a single layer of cuboidal follicular cells
Secondary follicle is
Second stage where the oocyte is surrounded by granulosa cells
Tertiary follicle is
oocyte is characterized by a fluid filled space called antrum
Graafian follicle is
Mature oocyte which ruptures to release ovum in ovulation. it is located eccentrically in follicle
Minor bleeding occuring as a result of rapture of follicle into abdominal cavity causes peritoneal irritaation called
Mittelschmerz pain
This hormone is required for ovulation to occur
LH
Stages of changes in endometrium in response to progesterone and estrogen
Proliferation
Secretion
Menstruation
Parts of endometrium and resposes to hormones
2 Layers
Functional layer consisting of compacta and spongioss which responds to hormonal stimulation
The basal layer which remains intact through menstrual cycle and does not respond to hormonal changes
At the end of menstrual period the functional layer is
sloughed off necrotic devoid of surface epithelium thin Glands are softened stroma infiltrated by white and red blood cells
Average blood loss in menstruation
30-80mL
Menstrual blood clots or not?
Menstrual blood is non clotting because of fibrinolysin
prescence of clot indicates a uterine pathology
Anovulatory cycles
Failuire to ovulate but have fairly regular menstrual cycles
Abnormal uterine bleeding
Causes heavy menstrual bleeding
Amenorrhea
No menstruation
Irregular menstrual bleeding
Bleeding between periods
Dysmenorrheaa
Painful menstrual periods
Pre menstrual syndromes
Physical and psychological symptoms associated with menstrual cycles
Hypomenorrhea
Scanty menses during norml menses
Menorrhagia
abnormally profuse flow during normal menses
Metrorrhagia
Bleeding from the uterus between periods
Oligomenorrhea
reduced frequency of periods
Causes of menorrhagia
Abnormalities in uterus like fibroids,polyps
Hormonal imbalances
Medical conditions
Medical conditions causing menorrhagia
Thyroid problems Blood clotting disorders, like von Willebrand dx Idiopathic thrombocytopenic purpura Liver or kidney dx leukemia medications like anticoagulants
Types of amenorrhea
Primary - Menstrual bleeding has never occurred
Secondary- Cessation of menstrual cycles in a woman with previous normal periods
Causes of primary amenorrhea
Abnormalities in endocrine system which produces hormones
Low body weight due to eating disorders
excessive exercise
medication
Ovarian dysfunction
Hypothalamic lesions or delayed maturation of pituitary glands
genetic abnormalities
Secondary amenorrhea causes
Pregnancy Problems that cause low estrogen-stress,weight loss,excercise,illness pitutary problems-Hyperprolactinemia ovarian disorders oophrectomy hypothalamic problems Thyroid problems
Dysmenorrhea often dissapears after
First pregnancy
occurs due to accumulation of prostaglandins in uterus
Physical symptoms of PMS
Bloating swollen, painful breasts constipation headaches clumsiness fatigue
Emotional symptoms of PMS
crying/depression anger anxiety moodswings tension lack of concentration
