Pathology of the Uterus Flashcards
What are the phases of the ovarian cycle?
Follicular phase, ovulation and luteal phase
What are the phases of the uterine cycle?
Menstrual cycle, proliferative phase and secretory phase
What are some features of the proliferative phase?
Lasts 1-14 days
Oestrogen is involved
Causes growth
What are some features of the secretory phase?
Lasts 16-28 days
Progesterone is involved
Causes secretion
What are some features of the menstrual cycle?
Lasts 1-3 days
Hormones withdrawn
Causes necrosis
What are some features of the fertilised phase?
Continues from the secretory phase onwards
Progesterone and HCG involved
Causes hypersecretion and decidualisation
What are the indications for endometrial sampling?
Abnormal uterine bleeding
Investigations for infertility
Spontaneous and therapeutic abortion
Assessing response to hormonal therapy
Endometrial ablation
Endometrial cancer screening if high risk
Work up prior to hysterectomy for benign indications
Incidental finding of thickened endometrium on scan
What are the types of abnormal uterine bleeding (AUB)?
Menorrhagia, metrorrhagia, polymenorrhoea, polymenorrhagia, menometrorrhagia, amenorrhoea, oligomenorrhoea
What is menorrhagia?
Prolonged and increased menstrual flow
What is metrorrhagia?
Regular intermenstrual bleeding
What is polymenorrhoea?
Menses occurring at <21 day intervals
What is polymenorrhagia?
Increased bleeding and frequent cycle
What is menometrorrhagia?
Prolonged menses and intermenstrual bleeding
What is amenorrhoea?
Absence of menstruation >6 months
What is oligomenorrhoea?
Menses at intervals of >35 days
What is dysfunctional uterine bleeding (DUB)?
Abnormal uterine bleeding with no organic cause
What is PUB?
Abnormal uterine bleeding > 1 year after cessation of menstruation
What are the causes of AUB in adolescence?
DUB usually due to anovulatory cycles
Pregnancy or miscarriage
Endometritis and bleeding disorders
What are the causes of AUB during reproductive life and perimenopause?
Pregnancy or miscarriage
Endometritis and bleeding disorders
Leiomyoma, hyperplasia, cervical/endometrial cancer
DUB = anovulatory cycle, luteal phase defect
Endometrial/endocervical polyp
Adenomyosis or exogenous hormone effects
What are the causes of AUB post menopause?
Atrophy, hyperplasia or endometritis
Endometrial polyp or bleeding disorder
Endometrial carcinoma or sarcoma
Exogenous hormones = HRT, tamoxifen
What endometrial thickness would be an indication for a biopsy?
Thickness >4mm in post-menopausal women
Thickness >16mm in pre-menopausal women