Obs and Gynae history Flashcards
[gynae] MS COURS stand for
Menstrual Cycle
Sexual History
Contraception
Obstetric Hx
Urinary Sx
Rectal Sx
Smears (if >25)
[gynae] Menstrual cycle features
- LMP
- length and regularity
- abnormal bleeding
- heavy flow
- painful bleeding (dysmenorrhoea)
- pelvic pain
- post-menopausal bleeding
Why is LMP relevant?
Check for possible pregnancy
Why is length and regularity of the cycle important?
check for PCOS and dysfunctional uterine bleeding
Why is abnormal bleeding important?
- dysfunctional uterine bleeding
- STI
- PID
- cancer
- ectropion
what are the red flag types of bleeds and what do they possibly indicate?
1) inter-menstrual bleeding–> cervical cancer
2) post-coital bleeding –> STI, cervical cancer
3) post-menopausal bleeding–> endometrial cancer
why is heavy bleeding important?
- fibroids
- malignancy
- dysfunctional uterine bleeding
- clotting
why is dysmenorrhoea important?
- endometriosis
- adenomyosis
why is pelvic pain important?
- endometriosis
- chronic PID
- non-gynae causes e.g. GI, bladder
why is PMB important?
- atrophic vaginitis
- polyps
- cervical cancer
- endometrial cancer
How do you ask about LMP?
“When was your first day of your last period?”
How do you ask about length and regularity?
“Are your cycles regular?”
“how long are they and how often do you bleed for?”
How to quantify bleeding?
“How often do you have to change your pads in a day?” or “how many pads do you wear in a day?”
how do you ask about dysmenorrhoea?
“is there pain prior to the period starting or is there pain throughout?”
What does time of menarche and menopause tell you?
How long they’ve been exposed to oestrogen for.
Those with early menarche and late menopause are considered to be at increased risk to ovarian cancer (due to prolonged oestrogen exposure).
Late menopause is also a risk factor for endometrial cancer.
