Menstruation Disorders Lecture Flashcards
Define menstruation
Monthly cycling of female reproductive hormones
- Time between onset of one to onset of the next period
Usually 28 days
Usually last 4 days
Blood loss of 30-80 mL
Complex interplay between the hormones of the?
Hypothalamus
Pituitary gland
Ovaries
Major events per menstrual cycle?
Proliferative (follicular) phase: maturation and release of an ovum from the ovaries
Secretory (luteal) phase: prep of endometrial lining for implantation of egg
Define dysmenorrhea
Difficult or painful menstruation
90% experience
Primary: only if ovulatory cycle
Secondary
Primary dysmenorrhea?
13-17 Normal flow Last 1-3 days No other pain Responds to NSAIDS and OCs Cramping, fatigue, aches, nausea, irritability change in appetite
Secondary dysmenorrhea?
Mid to late 20s Irregular with heavy and prolonged flow Pattern/intensity vary Pain other times Doesn't respond to NSAIDS or OCs Dyspareunia, pelvic tenderness
Primary is self treatable if?
Directly related to period
Not sexually active
Previously diagnosed
Secondary cannot be self treated because?
Can have: endometriosis
PID, ovarian cysts, unterine tumors
Exclusions for self care of dysmenorrhea
Severe Inconsistent with primary History of PID, infertility, cysts, IUD, etc Allergy to Aspiring or NSAIDS History of bleeding disorder
Nonpharmacologic treatment of primary dysmenorrhea?
Hot baths Heating pads Regular exercise Adequate sleep Complementary: B1, magnesium, vitamin E
Pharmacologic treatment of primary dysmenorrhea?
Acetaminophen
Aspiring
Ibuprofen
Naproxen sodium
Acetaminophen as a treatment?
Mild symptoms
Weak inhibitor of PG synthesis
Aspirin as a treatment?
Mild symptoms
Minimal effect on PG synthesis
May increase flow
Less than 19 precaution
Nonsalicylate NSAIDs as a treatment?
60-90% effective
Avoid if trying to get pregnant
Counseling for NSAIDS
Being at onset
Use a schedule
Switch between drugs
Talk to PCP
Define PMS
Cyclic disorder: occurs during luteal phase (1 week prior to menses) and is triggered by hormonal fluctuations
Combo of physical, emotional/mood, and behavioral symptoms
Disappear by end of period
Physical symptoms?
Breast tenderness
Bloat
Lower backache
Food cravings
Changes in mood?
Irritability
Emotional lability
Lowered mood
Depression, anxiety, anger
Define Premenstrual dysphoric disorder
Five or more physical/mood symptoms
One sx significant: depression, anxiety, anger
Interferes with work, school, relationships
No underlying disorder
Exclusion to self-care for PMS
Severe PMS or PMDD
Uncertain patterns of symptoms
Onset of symptoms starts with hormone therapy
Contraindication for OTCs
Nonpharmacologic treatment of PMS
Aerobic exercises (increase endorphins) Dietary changes (balanced diet, decrease salt, sugar, alcohol, increase carbs) Cognitive-behavioral therapy (reduce stress)
Pharmacologic treatment of PMS?
Pyridozine (B6) –> improve mood
Calcium and Vitamin D –> reduce emotional symptoms, food craving, physical symptoms
NSAIDS –> reduce pain
Diuretics –> reduce bloating
Define diuretics
Relieve water retention, bloating, swelling, weight gain
- Caffeine, pamabrom
Caffeine does what?
Inhibits reabsorption of sodium and water
Tolerance may develop
ADR: irritability, anxiety, insomnia
Pamabrom?
Most common
Define toxic shock syndrome
Caused by toxin=producing straings of S. aureus or pyogenes
13-19
Linked to tampon use, IUDs, cervical caps or diaphragms
Symptoms of toxic shock syndrome?
Malaise, chills, GI symptoms
High fever, vomiting and diarrhea, rash, decrease urine output, hypotension, shock
Counseling for TSS?
Risk is ZERO if not using tampons
Use lowest absorbency tampons
Wast hands
Do not leave in longer than recommended
