Women's Health Flashcards
Define menopause
Transition when ovaries stop releasing eggs, menstrual activity decreases and eventually ceases. Generally defined as 1 year without menstruation.
Why would women with menopause experience dypareunia?
Vaginal walls become less elastic, thinner, and shorter. Also, secretions decrease and change consistency.
For women, decrease in pelvic muscle tone can cause what?
Increase risk of prolapse: bladder, vaginal, and uterus
Increase risk of stress incontinence.
Define endometriosis
Endometrial tissue becomes implanted outside the uterus.
What is the pathogenesis of endometriosis?
Cause is unknown. Most common theory: menstrual blood containing endometrial cells is retrogradely flushed back through fallopian tubes into pelvic cavity.
What are the key clinical signs of endometriosis?
- Dysmenorrhea
- Dyspareunia
- Infertility
What are your treatment options for Endometriosis?
There is no cure: medical goal is pain relief and preservation of fertility.
Pregnancy and menopause stop continued development but won’t stop current implants.
Define endometrial cancer
Cancer of the uterine lining (endometrium)
Name the risk factors for endometrial cancer.
- Increasing age >60 y.o.
- Obesity
- Increased levels of estrogen
* * 4. Inactivity! (women who exercise are less likley to develop than women who do not exercise)
Define the clinical presentation for endometrial cancer
- Abnormal bleeding: Vaginal bleeding 1 yr after menopause
2. Abdominal/ LE edema (lymphatic metastases)
Define Cervical cancer
Cancer that forms in the cervix
What is the primary cause of cervical cancer?
HPV (human papilloma virus)
How does HPV affect cervical cancer?
HPV essentially turns off cells’ tumor-suppressing genes, allowing abnormal changes in cervical epithelium
Describe the early stages and advanced stages of cervical cancer.
Early stages: Asymptomatic
Advanced stages: abnormal vaginal bleeding, bowel/ bladder problems
Define ovarian cancer
Malignant neoplasm located on the ovaries
What is the leading cause of death from gynecologic cancers and why?
Ovarian cancer, due to the fact that 60-70% of women have metastatic disease at the time of diagnosis
How is ovarian cancer diagnosed?
There is no cost-effective screening test for ovarian cancer but pelvic examination may reveal ovarian or abdominal mass
What are the risk factors for ovarian cancer?
- Age > 40 yr
- Nulliparity; women who never breast-feed
- Family history of breast, ovarian, or colon CA
- Personal history of breast or endometrial CA
- Presence of mutation in BRCA1 or BRCA2 genes
- Caucasian
What should a PT note about ovarian cancer due to risk of recurrence?
PT should note any gait disturbances as that may be sign of paraneoplastic syndrome (PCD)
Define Ectopic pregnancy
Implantation of a pregnancy in any location otehr than the uterus, often in a fallopian tube (tubal pregnancy)
What are the risk factors for ectopic pregnancy?
- STDs
- Prior tubal surgery
- Current use of intrauterine contraceptive device
- Pelvic inflammatory disease
- Previous ectopic pregnancy
Describe the pathogenesis of ectopic pregnancy
It’s a delayed ovum transport due to decreased Fallopian tube motility. Fertilization and implantation occurs in the tube. Also, pregnancy outgrows blood supply. So pregnancy terminates with vaginal bleeding and possible rupture of Fallopian tube.
How serious is a rupture of the Fallopian tube with an extopic pregnancy?
Rupture is a medical emergency due to rapid intra-abdominal hemorrhage. Women can go into shock with this.
Describe the clinical presentation of ectopic pregnancy
- Vaginal bleeding during menstrual period
- Classic pain: sudden, sharp, stabbing
- Pain may be gradual onset: low back, one or other hip and shoulder strap pain, especially with inspiration
If the therapist suspects ectopic pregnancy, what type of referral is warranted?
An urgent referral is warranted because of this is a potentially life-threatening condition
How is an ectopic pregnancy diagnosed?
- A pelvic ultrasound: an empty uterus and presence of gestational sac in tube.
- An elevated human chorionic gonadotropin (hCG)
- Laparoscopy
Define breast cancer
Malignant neoplasm of breast (in lobules or ducts)
What is the most common cancer among women?
Breast cancer
What are the risk factors for breast cancer?
- Female sex & age >= 60 years
- Young age at menarche ( < 12 years old = greatest risk)
- Age at 1st live birth ( >35 years old = greatest risk)
- First-degree relatives with breast CA increases risk
- At least one abnormal biopsy
- Mutation in BRCA1 or BRCA 2 genes
- Being white
- Long term use of BCPs or combined HRT
- Physical inactivity
- Weight gain later in life
What is the most common site of metastases for breast cancer?
- Bone
- Lungs
- Liver
- Skin
- Adrenal glands
- Brain
True or False? Estrogen likely initiates breast cancer disease, as well as promotes its progression.
False, it does not initiate the disease but rather promotes its progression.
True or False? Estrogen does not initiate breast cancer disease, but promotes its progression.
True!
What is the most common clinical presentation for breast cancer?
Palpable new lump or nodule in the breast.
What areas are more common for lumps to appear in men and women with breast cancer?
In women: more likely in upper lateral quadrant
In men: more likely behind areola
Describe the clinical presentation for breast cancer
- Palpable new lump or nodule
- Breast changes: generalized swelling, skin irritation, nipple pain or retraction
- Lymphadenopathy may be initial symptom
- Later in course: UE edema, bone pain, weight loss, jaundice
What is the difference in screening recommendations between the American Cancer Society and U.S. Preventative Services Task Force?
There’s no recommendation of self-breast exam from the U.S. Preventative Services Task Force
How frequent does metastases with breast cancer occur?
Most frequently within 2-3 years of initial diagnosis.
Hence, be ware of lump or NEW onset of edema in upper quadrant
Why is exercise beneficial for individuals with breast cancer?
- It has a protective effect against breast CA in pre- and post-menopausal women
- It helps maintain functional ability and reduce fatigue in women with breast CA receiving chemotherapy
- Moderate activity after diagnosis decreases risk of mortality due to breast CA
- Prevents loss of ROM and adhesive capsulitis for women that experiences a chronic neuropathic syndrome called postmastectomy pain syndrome (PMPS)
