Tx: Menstruation & Menopause Flashcards
Tx from lectures: - Menstrual cycle - Menopause
1
Q
Dysmenorrhea
A
- Local heat
- Vitamin E 500 IU 2 days before and 3 days into menses
2
Q
Primary dysmenorrhea
A
- NSAIDs
- OCPs
- Smoking cessation
3
Q
Premenstrual syndrome (PMS)
A
- SSRIs - fluoxetine
- OCPs
- Diuretics - Spironolactone
4
Q
Premenstrual dysphoric disorder (PMDD)
A
- SSRIs - Fluoxetine, buspirone
- Exercise, stress management
- OCPs
- GnRH agonists (Leuprolide)
5
Q
Menorrhagia - Pharm (6)
A
- NSAIDs - Naproxen 500mg BID at bleeding onset x 5 days
- OCPs
- GnRH agonists (Leuprolide)
- Danazol
- Conjugated estrogens
- Tranexamic acid
6
Q
Menorrhagia - Procedural (4)
A
- D&C
- Endometrial ablation
- Myomectomy
- Hysterectomy
7
Q
AUB Acute
A
- IV estrogen
- High dose OCPs
- D&C
8
Q
AUB Anovulatory
A
- OCPs
- Medroxyprogesterone acetate - if estrogen CI
9
Q
AUB Ovulatory
A
- OCPs - Progesterone PO
- Mirena IUD
10
Q
AUB Surgery
A
- Hysterectomy
- Endometrial ablation
11
Q
Primary & secondary amenorrhea
A
Treat underlying cause
12
Q
PCOS (5)
A
- Lifestyle - diet, exercise, weight loss
- Insulin resistance: Metformin
- Combo OCPs - NO norgestrel or Levonorgestrel
- Hirsutism: Spironolactone
- Infertility: Clomiphene
13
Q
Ovarian cysts
A
<6-8 cm: Resolve spontaneously
- NSAIDs
- repeat pelvic US in 6 weeks
- OCPs if recurrent
Ruptured: Assess hemodynamic stability
14
Q
Ovarian torsion
A
Surgery
15
Q
Atrophic Vaginitis
A
- Supplemental estrogen (PO, transdermal, vaginal)
- Vaginal lubricants and moisturizer
16
Q
Menopause Symptomatic therapies
A
- Contraception for 1 year following menopause
- Hormone Replacement therapy - estrogen or estrogen+progestin if still have a uterus
- Progestogens
- Clonidine
- SSRIs
- SNRIs
- Gabapentin
17
Q
Perimenopause Lifestyle mods
A
- Lifestyle: diet, exercise, screenings (pap, colonoscopy, mammogram)
- Hot flashes:
- antidepressants (SSRIs)
- Soy products
- Daily exercise
- Avoid spicy foods, alcohol, and caffiene
