Menstruation Disorders Flashcards
what does FSH stimulate
ovarian follicle development and granulosa cells to produce oestrogens
what inhibits FSH production
raising oestrogen and inhibin by dominant follicles
what stimulates ovulation
prior LH surge
what happens in the proliferative phase
oestrogen induced growth of endometrial glands and stroma
what happens in the luteal phase
progesterone induced glandular secretory activity
endometrial apoptosis and subsequent menstruation
menstruation
arteriolar constriction and shedding of functional endometrial layer
fibrinolysis inhibits scan tissue formation
how much is lost during menstruation
30-40ml in normal menstruation
heavy bleeding is 80ml or more
what is menorrhagia
prolonged and increased menstruation flow
metrorrhagia
irregular, frequent bleeding or varying amounts but not excessive
polymenorrhoea
meses occurring at <21 day interval
polymenorrhagia
increased bleeding and frequent cycling
amenorrhoea
absence of menstruation >6 months
oligomenorrhoea
menses at intervals of >35 days
what are the causes of menorrhagia
presence of pathology-organic
non-organic-absence of pathology
also known as dysfunctional uterine bleeding
what are the organic causes of menorrhagia
fibroids adenomyosis endocervical or endometrial polyp cervical eversion endometrial hyperplasia intrauterine contraception device (IUCD) pelvic inflammatory disease (PID) endometriosis malignancy of the cervix of uterus
adenomyosis
condition in which the inner lining of the uterus breaks through the muscle wall-presence of endometrial tissue within the myometrium
what is dysfunctional uterine bleeding
50% of women with abnormal uterine bleeding
diagnosis made by exclusion
what are the 2 types of dysfunctional uterine bleeding
anovulatory and ovulatory
how is DUB diagnosed
it is a diagnosis of exclusion full blood count cervical smear TSH coagulation screen renal/liver function tests transvaginal ultrasound scan endometrial sampling
what is the management of DUB
progesterogens combined oral contraceptive pill danazol GnRH analogue NSAIDS antifibrinolytics
progestogen-releasing IUCD
what is danazol
giving testerone as a way of reducing oestrogen
what is the surgical management of DUB
endometrial resection/ablation
hysterectomy
what are the benefits of medical treatments
cheaper no waiting list no anaesthetic risks adverse effects non-permanent fertility is preserved
what are the possible causes of heavy bleeding
endometrial cancer PCOS underactive thyroid gland DUB pelvic infections
