Menstruation Disorders Flashcards
Primary amenorrhea definition
Absence of menses by age 15 in the presence of normal sexual development
Secondary amenorrhea definition
Absence of menses for 3 cycles for 6 months in a previously menstruating woman
Amenorrhea signs/symptoms
Infertility, vaginal dryness, decreased libido, weight loss/gain, acne, hirsutism, hair loss
Most common cause of amenorrhea
Unrecognized pregnancy
How to treat amenorrhea when excessive exercise or anorexia is the cause
Increase weight, decrease level of exercise
If that’s not effective, consider CHC
How to treat amenorrhea when hyperprolactinemia is the cause
Dopamine agonist
How to treat amenorrhea when the anovulation is secondary to PCOS
Figure out if pregnancy is an immediate goal:
Yes: weight loss and letrozole
No: weight loss and CHC with lower progesterone content
How to treat amenorrhea when it’s unknown
Progestin to induce withdrawal bleeding followed by estrogen/progestin therapy
Signs/symptoms of anovulatory bleeding
Irregular, heavy, or prolonged vaginal bleeding, perimenopausal symptoms (hot flashes, night sweats, vaginal dryness)
Treatment for anovulatory bleeding
NSAIDs, CHCs, medroxyprogesterone acetate
Clomiphene or letrozole if the goal is to induce ovulation and become pregnant
Signs/symptoms of menorrhagia
Heavy/prolonged flow
Fatigue, lightheadedness, pallor in cases of severe blood loss
May or may not have symptoms of dysmenorrhea
Nonpharm menorrhagia treatment
Rest, heat, wearing loose clothing, exercise, massaging/rubbing where it hurts, smoking cessation/avoidance
Pharm menorrhagia treatment
NSAIDs
PO CHC or POP
LNG IUD
PMS mood symptoms
Fatigue, irritability, labile mood, depression, oversensitivity, social withdrawal, crying spells, forgetfulness, difficulty concentration
PMS physical symptoms
Abdominal bloating, breast tenderness, acne, appetite changes and food cravings, swelling of extremities, headache, GI upset
