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[AMS] Reproductive System > S4) Menstrual Disorders > Flashcards

S4) Menstrual Disorders Flashcards

1
Q

Identify 7 common menstrual disorders

A
  • Amenorrhoea
  • Oligomenorrhoea
  • Menorrhagia
  • Dysmenorrhoea
  • Intermenstrual bleeding (IMB)
  • Dysfunctional uterine bleeding (DUB)
  • Premenstrual syndrome (PMS)
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2
Q

What is amenorrhea ?

A

Amenorrhea is the absence of menstruation

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3
Q

Distinguish between primary and secondary amenorrhea

A

- Primary amenorrhoea: failure to establish menstruation by 16 years

  • Secondary amenorrhoea: cessation of previously normal menstruation for ≥ 6 months
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4
Q

Identify some physiological causes of amenorrhea

A
  • Prepubertal
  • Pregnancy
  • Menopause
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5
Q

How can pathology be determined in amenorrhea?

A
  • Pathology occurs at the various levels of endocrine control
  • Gonadotrophin levels indicate the level of the pathology
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6
Q

Identify the different types of pathology in amenorrhea

A
  • Hypothalamic
  • Pituitary
  • Ovarian
  • Uterine/endometrial
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7
Q

What is oligomenorrhea?

A

Oligomenorrhoea is infrequent menstruation >35 days i.e. 4-9x per year

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8
Q

What is menorrhagia/heavy menstrual bleeding?

A

Menorrhagia/HMB is a complaint of excessive menstrual blood loss over consecutive cycles or >80 mls per menstruation

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9
Q

Identify 6 common causes for menorrhagia

A
  • Leiomyoma (uterine fibroids)
  • Uterine polyps
  • Endometrial cancer
  • Bleeding diathesis
  • Copper from IUD coil
  • Drugs e.g. warfarin
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10
Q

What is dysmenorrhea?

A

Dysmenorrhoea is pain during menses, associated with ovulatory cycles

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11
Q

Distinguish between primary and secondary dysmenorrhea

A
  • Primary dysmenorrhea is idiopathic, due to response of the uterus to local prostaglandins, hence painful contractions
  • Secondary dysmenorrhea can be due to endometriosis or obstructed menses
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12
Q

What is dysfunctional uterine bleeding?

A

DUB is heavy and irregular menstrual bleeding that occurs secondary to an ovulation

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13
Q

What is premenstrual syndrome?

A

- PMS is a cyclical disorder, occurring in latter half of the menstrual cycle

  • Symptoms could be physical or psychological and resolve with onset of menstruation
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14
Q

What is premenstrual dysphoric disorder?

A

Premenstrual dysphoric disorder is the severe end of the spectrum of PMS with extreme mood symptoms

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15
Q

Outline the Female HPO axis

A
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16
Q

Identify 7 possible causes of menstrual disorders

A
  • Hormonal e.g. HPO axis
  • Chromosomal anomalies
  • Structural/Anatomical (uterine or vaginal)
  • Bleeding diathesis
  • Drugs
  • Thyroid disease
  • Chronic illness
17
Q

Identify 4 chromosomal abnormalities which can cause menstrual disorders

A
  • Turner’s syndrome
  • Androgen insensitivity syndrome
  • Swyer syndrome
  • Congenital adrenal hyperplasia (CAH)
18
Q

Identify 5 structural causes of menstrual disorders

A
  • Agenesis/hypoplasia of the genital tract
  • Leiomyoma
  • Imperforate hymen & vaginal septae
  • Asherman’s syndrome
  • Cervical stenosis
19
Q

Be able to identify an imperforate hymen

A
20
Q

Be able to identify uterine fibroids

A
21
Q

Oligomenorrhea is a feature of hormonal contraception but also has other causes.

Identify 4 of them

A
  • Infection (STI/PID)
  • Cervical ectopy or pathology
  • Endometrial pathology (polyp or cancer)
  • Ovarian cyst
22
Q

Identify 7 components of a comprehensive history on a patient with a menstrual disorder

A
  • Emphasis on age
  • Onset of puberty
  • Pain – cyclical or not
  • Menstrual history – cycle, volume, change etc
  • Sexual history
  • Medical history
  • Symptoms
23
Q

What 4 types of examinations should one perform when examining a patient with a menstrual disorder?

A
  • General
  • Abdominal
  • Speculum
  • Bimanual
24
Q

What 5 things should one look out for when performing an examination on a patient with a menstrual disorder?

A
  • Presence or absence of secondary sexual characteristics
  • Appearance of known chromosomal abnormalities
  • Swellings/lumps/masses
  • Discharge
  • Pattern of hair growth
25
Q

Identify and describe 4 types of investigations one can perform for a patient with a menstrual disorder

A
  • Blood hormone profile – gonadotrophins, karyotype, thyroid function, FBC
  • Imaging – USS, MRI
  • Hysteroscopy – diagnostic and therapeutic
  • Laparoscopy – diagnostic and therapeutic
26
Q

Outline the pharmacological and surgical management of menstrual disorders

A
  • Pharmacological – use of gonadotrophins, progesterone, combine oral contraceptive pill and hormone replacement therapy
  • Surgical – depends on the condition

[AMS] Reproductive System (21 decks)

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