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Flashcards in 10. Menses Deck (70):
1

Menarche (def)

Onset of menstruation during puberty

2

When does menses begin? (4)

• When the brain, ovaries and adrenal glands are mature
• When body fat is adequate

3

Perimenopause (def)

Period of time when ovarian function regresses (process, not event)

4

Climacteric (def)

A period of reproductive decline

5

Menopause (diagnostic def)

When a woman has stopped bleeding for 12 months -- retrospective diagnosis.

6

Hormonal changes with menopause

Ovaries no longer producing estrogen, progesterone

7

Role of estrogen (menses) (6)

• Control the development of the female secondary sex characteristics
• Assists in the maturation of the ovarian follicles
• Ensures that the endometrial mucosa is in a ready state
• Estrogens also cause the uterus to increase in size and weight
• Hormonal regulation
• Increases libidinal feelings in humans

8

Secondary sex characteristics controlled by estrogen (4)

o Beast development
o Growth of body hair
o Widening of the hips
o Deposits of the tissue (fat) in the buttocks and mons pubis

9

Progesterone is secreted by ____

The corpus luteum

10

Progesterone is found in the greatest amounts during what phase of the menstrual cycle?

The luteal phase

11

Functions of progesterone (2)

• Decreases uterine motility and contractility caused by estrogens
• Causes the uterine endometrium to further increase its supply of life-sustaining components

12

Progesterone causes the uterine endometrium to further increase its supply of (5)

• glycogen
• arterial blood
• secretory glands
• amino acids
• water

13

Prostaglandins (def)

Oxygenated fatty acids that are produced by the cells of the endometrium

14

Two types of prostaglandins discussed in class

Prostaglandin E (PGE)
Prostaglandin F (PGF)

15

Characteristics of PGE (3)

PGE = Potent vasodilator
o Relaxes smooth muscle
o In sperm

16

Characteristics of PGF (2)

PGF = Potent vasoconstrictor
o Increases the contractility of muscles and arteries

17

Menstruation (def)

Periodic uterine bleeding that begins approximately 14 days after ovulation

18

Hypothalmic-pituitary (menstruation - def)

Negative feedback cycle that stimulates ovaries

19

Ovarian (menstruation - def)

Cyclic selection of a mature oocyte for ovulation

20

Endometrial (menstruation - def)

Cyclic proliferation and shedding of functional layer of the endometrium

21

3 concurrent cycles in menses:

• Hypothalmic-pituitary
• Ovarian
• Endometrial

22

Hormones involved in the hypothalmic-pituitary cycle

GnRH (Gonadatropin Stimulating Hormone)

23

Phases of the ovarian cycle, and when each occurs (2)

• Follicular Phase: Days 1-14
• Luteal phase: Days 15-28

24

What occurs during the follicular phase of the ovarian cycle?

One follicle is "selected" for ovulation

25

Follicular phase: Dominant hormone

Estrogen

26

What happens during ovulation? (Timing, hormones)

o Estrogen from ovarian follicles stimulates LH surge
o Occurs 34-36 hours after the LH surge begins (10-12 hours after LH peak)

27

What occurs during the luteal phase of the ovarian cycle?

What was the follicle becomes the corpus luteum

28

Luteal phase: Dominant hormone

Progesterone

29

Phases and timing of the endometrial cycle (4)

• Menstrual phase (Days 1-5)
• Proliferative Phase (Days 6-14)
• Secretory phase (Days 15-26)
• Ischemic phase (Days 26-28)

30

Menstrual phase of endometrial cycle: What happens + hormonal reason

Shedding of the endometrium due to low estrogen levels

31

Proliferative phase of endometrial cycle: What happens?

• Period of rapid endometrial thickening
• Restoration of endometrial surface

32

Secretory phase of the endometrial cycle: What occurs (and why)? (3)

• Endometrium becomes edamatous and vascular (enables blood supply for implanted ovum)
• Glycogen secreted (to prepare for fertilized ovum)
• Progesterone increased from corpus luteum

33

Ischemic phase of endometrial cycle: What happens (2)

• Levels of estrogen and progesterone fall rapidly
• Corpus luteum degenerates

34

Three other cyclic changes surrounding menstruation

• Basal Body Temperature changes
• Spinnbarkheit
• Miittelschmirtz

35

Changes in basal body temperature (2)

o Lowers prior to ovulation
o Elevates post-ovulation -- Due to a rise in progesterone

36

Spinnbarkheit (def)

Cervical mucus thin and stretchable (egg whites)

37

Miittelschmirtz (def)

One-sided lower abdominal pain that coincides with ovulation

38

Five menstrual cycle irregularities

o Amenorrhea
o Oligomenorrhea
o Menorrhagia
o Metrorrhageia
o Dysfunctional Uterine bleeding (DUB)

39

Amenorrhea (def)

Lack of period

40

Oligomenorrhea( def)

Light period

41

Menorrhagia (def)

Excessive menstrual bleeding in duration or amount

42

Metrorrhageia (def)

Spotting or hemorrhaging between normal cycles

43

DUB (def)
3 characteristics

Dysfunctional Uterine Bleeding

*Any bleeding that is irregular in amount, duration or timing and not related to normal menstrual bleeding. *Usually excessive.
*Associated with ovulation.

44

Primary amenorrhea (2)

• Absence of menarche and secondary sex characteristics by age 14
• Absence of menarche regardless of secondary sex characteristics by age 16

45

Secondary amenorrhea

• A six month cessation of menses after a period of menstruation

46

Causes of amenorrhea (7)

• Pregnancy
• Various diseases
• Stress
• Eating disorders
• Strenuous exercise
• Hormonal contraceptive
• Menopause

47

Dysmenorrhea (Def)

Painful menstruation

48

Dysmenorrhea (prevalence)

Affects 50-80% of women

49

Primary dysmenorrhea (def)

Associated with ovulatory cycles

50

Secondary dysmenorrhea (def)

Acquired menstrual pain developed later in life ( >25 years old)

51

Symptoms associated with primary dysmenorrhea (5)

• Backache
• Weakness, dizziness, syncope
• Sweating
• GI upset, anorexia, diarrhea, nausea, vomiting
• Headache

52

Primary dysmenorrhea: Treatment (2)

NSAIDs, fluids

53

Cause of primary vs Secondary dysmenorrhea:

Primary dysmenorrhea: Associated with ovulatory cycles

Secondary dysmenorrhea: Associated with pelvic pathology

54

Five types of pelvic pathology associated with secondary dysmenorrhea

• Adenomyosis
• Endometriosis
• Pelvic Inflammatory Disease (PID)
• Polyps
• Fibroids

55

Adenomyosis (def)

Endometrial tissue that grows into the muscular wall

56

Endometriosis (def)

Endometrial lining grows outside of the uterus

57

Premenstrual syndrome (def)

Physical and psychological symptoms beginning in the luteal phase of the menstrual cycle

58

Premenstrual syndrome: Symptoms (6)

• Water retention
• Behavioral/emotional changes
• Premenstrual cravings
• Headache
• Fatigue
• Backache.

59

Treatment for Premenstrual syndrome (3)

* NSAIDs
* Loop diuretic (Lasix) for bloating
* SSRIs for mood stabilization

60

Endometriosis: Characteristics (6)

• Secondary amenorrhea
• Dyspareunia – Painful intercourse
• Abnormal uterine bleeding
• Infertility
• Pain during exercise because of adhesions
• Bowel problems – endometrium can go into bowel

61

Endometriosis treatment (2)

NSAIDs
Heat (to increase bloodflow to the pelvis)

62

Endometriosis Diagnosis (2)

Ultrasound, clinical history

63

Uterine polyps: Def

o Tumors on stalks arising from mucosa

64

Where can uterine polyps occur? (2)

• Endometrial
• Cervical

65

What are the most common benign lesions of the cervix and endometrium occurring in reproductive years?

Uterine polyps

66

What are fibroids

Benign, slow-growing tumors

67

Fibroids: Types (5)

• Intramural
• Subserosal
• Submucosal
• Cervical
• Pedunculated

68

Which type of fibroid is least common & most symptomatic? Why?

SUBSEROSAL
• Affects the menstrual cycle

69

Four causes of fibroids

• Hormone replacement therapy (HRT)
• Estrogen Replacement therapy (ERT)
• Pregnancy
• Oral contraceptive pills

70

Treatment of fibroids (3)

• NSAIDs for inflammation
• Oral contraceptive pills (Keeps level stable)
• Myomectomy – removal