Women's Health Flashcards
Layers of uterus
- Peritoneum
- Myometrium
- Endometrium
Where does embryo implantation occur?
Endometrium
Oocytes travel to the uterus via ________
Fallopian tubes
Where does fertilization occur?
Distal end of Fallopian tubes (adjacent to ampulla)
____-day cycle from primordial follicle to dominant/Graafian follicle
120
Normal menarche occurs at age _____
8-15
Normal cycle length is ___ days
21-35
Polymenorrhea is….
<21 day cycle
Oligomenorrhea is….
> 35-day cycle
Metrorrhagia is…
Bleeding at irregular intervals
Normal menses lasts ____ days.
1-8
Menses is abnormal in length if it lasts…..
> 8 days
Menorrhagia is….
Abnormally heavy bleeding at REGULAR intervals
Menometrorrhagia is….
Abnormally heavy bleeding at IRREGULAR intervals
Term for ovulation/mid-cycle pain
Mittelschmerz
Give a brief overview of the menstrual cycle
Low estradiol (menstruation) → GnRH from hypothalamus → LH & FSH from ant. pituitary → follicular growth → elevated estradiol mid-cycle → LH surge → ovulation → corpus luteum forms and turns into corpus albicans and progesterone rises → estrogen & progesterone levels fall
Ovarian cycle consists of what stages?
Follicular phase → Ovulation → Luteal Phase (always 14 days)
Oocytes are surrounded by ______ cells and ______ cells
granulosa & theca
What do theca cells do?
Contain LH receptors → produce androgens
What do granulosa cells do?
Contain FSH receptors → produce estrogen & convert androgens to estrogens
Corpus luteum produces _____
progesterone
What are the phases of the uterine cycle?
Proliferative phase → Secretory phase → Menses
Criteria for diagnosing primary amenorrhea
Never had period by age 15 but has normal secondary sex characteristics
Criteria for diagnosing secondary amenorrhea
Pt has normally regular cycles but stops having menses for >3 cycles OR has normally irregular cycles but stops having menses for >6 cycles
Most common cause of secondary amenorrhea is….
Pregnancy!
Labs for diagnosing amenorrhea
HcG (r/o pregnancy first!) FSH TSH PRL \+/- testosterone (acne, hirsutism, PCOS)
Treatment for amenorrhea
- Correct underlying pathology
- Help achieve fertility if needed
- Psychological counseling
+/- Surgery
Dysmenorrhea is….
Recurrent crampy lower abdominal pain during menstruation without pelvic pathology
What causes dysmenorrhea?
Excess production of endometrial prostaglandin → incr. intrauterine contraction → ischemia, pain
Tx for dysmenorrhea
- NSAIDs (take w/ food) - ibuprofen or naproxen preferred, mefenamic acid alt.
- Hormones (suppress ovulation)
Criteria for diagnosing PMS
- Occur repetitively in 2nd half of menstrual cycle
- Resolve after menses starts
- Interferes with some aspects of life
- Must occur in at least 3 consecutive cycles
What sx’s occur with PMS?
Physical, emotional, behavioral, cognitive sx’s
Physical sx’s incl. breast tenderness, bloating, constipation, H/A, fatigue, hot flashes
Important to assess _____ in PMS pts
Impact on quality of life and suicide risk
Tx for PMS
- Mild → exercise, stress reduction techniques
- Moderate-severe:
SSRIs (preferred)
OCPs +/- low-dose alprazolam
GnRH agonist w/ low-dose estrogen-progestin replacement
Surgery
What is PMDD?
Premenstrual dysphoric disorder - severe form of PMS
What is dysfunctional uterine bleeding? When does it usually occur?
- Abnormal bleeding unrelated to anatomical lesions, pelvic pathology, pregnancy, other dz
- Commonly occurs right after menarche and during perimenopause
