periods Flashcards
when is follicular phase of menstruation and what happens
day 1-14 // raised FSH + oestrogen –> follicle growth // endometrium thickens and mucous thins
what day is ovulation
day 14
when is the luteal phase and what happens
day 14-28 // corpus luteum forms which secretes progesterone // endometrium is mainteined and mucous thicks // eventually tissue sheds when no hCG is produced
effect of FSH on hormones
stimulates follicle growth + granulosa cells –> oestrogen
effect of LH on hormones
stimulates theca cells to convert cholesterol –> androgens
what is mittelschmerz
ovulation pain in middle of the cycle
when does PMS occur
luteal phase (just before period)
symtoms PMS
anxiety, stress, fatigue, mood swings // bloating, breast pain
lifestyle advice PMS
good sleep + exercise // limit smoking + alcohol // eat frequent meals, rich in carbs
medication for PMS
new generation COCP // if severe SSRI (continuously or in luteal phase)
what is dysmenorrhoea
excessive pain during mentruation
what is Primary dysmenorrhoea
no underlying pathology
when is Primary dysmenorrhoea most common
within 1-2 years of menarche (excessive PGE)
symptoms Primary dysmenorrhoea
pain just before or just after staring period // suprapubic cramps –> radiate down back into thighs
mx Primary dysmenorrhoea
1 = NSAIDs eg mefenamic acid (inhibit PGE) // 2 = COCP // (IUS)
causes Secondary dysmenorrhoea
endometriosis // adenomyosis // PID // IUD (copper not IUS) // fibroid
onset Secondary dysmenorrhoea
years after menarche // pain starts 3-4 days before periods
mx Secondary dysmenorrhoea
refer to gynae
what is menorrhagia
total blood loss >80ml
causes menorrhagia
DUB (most common) // anovulatory cycles // fibroids // hypothyroid // copper coil (IUD) // PID // bleeding disorder
what is dysfunction uterine bleeding
most common cause menorrhagia - no underlying pathology
invx menorrhagia
FBC
what further testing is used in menorrhagia and when is it indicated
TVUS // IMB, PCB, abnormal abdo exam)
mx for patient with menorrhagia who does not what contraception
1 = tranexamic acid 1g // 2 = mefenamic acid 500mg (esp if pain)
mx for patient with menorrhagia who DOES what contraception
1 = IUS (mirena) // 2 = COCP or // 3 = long acting progesterone // 4 = GnRH analogue
short term rapid mx of heavy periods
norethisterone
mx menstrual migraines
mefanamic acid OR aspirin, paracetamol, caffeine // triptan in acute
