S5 L1 Menstrual disorders Flashcards

1
Q

Menstrual disorders
- What type of things to consider?

Menstrual disorders to be addressed
- 4 types

A

To be replaced by simple descriptive terms which cover:

  • regularity of the cycle
  • frequency of menstruation
  • volume and duration of the menstrual flow

Menstrual disorders:
• Amenorrhoea- primary and secondary
• Oligomenorrhoea
• Menorrhagia- Heavy Menstrual Bleeding (HMB)
• Dysmenorrhoea

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2
Q

Amenorrhoea:

  • What is this?
  • 2 types
A

• Amenorrhoea = absence of menstruation

• Primary amenorrhoea: failure of menstruation by the age of 16 years in the presence of normal secondary sexual characteristics, or 14 years in the absence of other evidence of puberty.
May be as simple as delayed puberty, or something else…
• Secondary amenorrhoea: absent periods for at least six months in a woman who has previously had regular periods, or 12 months if she has previously had oligomenorrhoea (bleeds less frequently than six-weekly).

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3
Q

Causes of Amenorrhoea

A
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4
Q

Oligomenorrhoea

Menorrhagia/Heavy menstrual bleeding

Dysmenorrhoea

A
  • Oligomenorrhoea: infrequent menstruation, >35 days i.e. 4- 9x/year
  • Menorrhagia/Heavy menstrual bleeding (HMB): excessive menstrual blood loss (MBL) that interferes with the physical, social, emotional and/or material quality of life.
  • The classic objective criteria of blood loss >80 mL/cycle may be applied for research purposes but not clinical use.
  • Dysmenorrhoea: means pain at the time of menstrual bleeding. e.g. could be caused by malignancy, endometriosis
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5
Q

Causes - Primary Amenorrhea

  • Type of causes
  • Examples include…
A
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6
Q

Causes - Primary Amenorrhea
– Turner syndrome

A
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7
Q

Causes - Primary Amenorrhea
– Complete Androgen Insensitivity Syndrome

A

Have the external sex characteristics of females, but do not have a uterus (due to no duct forming…) and therefore do not menstruate and are unable to conceive a child (infertile).

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8
Q

Causes - Primary Amenorrhea
- Diseases in the hypothalamus and pituitary

A
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9
Q

Clinical checklist for Primary Amenorrhea

A
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10
Q

Secondary amenorrhea - Anatomical causes

A
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11
Q

Secondary amenorrhea - PCOS

  • Symptoms
  • Levels of hormones
  • Insulin link
  • Tests for it
  • Treatment
A
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12
Q

Secondary amenorrhea - Endocrine

A
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13
Q

Secondary amenorrhea - Hypothalamic and pituitary disease

A
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14
Q

Physiological Amenorrhea
- 2 in specifically

A
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15
Q

Oligomenorrhoea

  • What is this?
  • Usually which phase is increased?
  • Causes?
  • Examples…
A

Can be a bit of a grey area when determining oligomenorrhoea or amenorrhoea

  • More correct terminology- infrequent menstruation
  • Usually due to prolonged follicular phase
  • Can be constitutional (it can ‘just happen’)
  • Most are directly or indirectly rooted in hormonal imbalance
  • Examples include: PCOS; ovarian insufficiency; perimenopause; thyroid dysfunction; excessive exercise; eating disorders; hormonal contraception
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16
Q

Menorrhagia

  • What is this?
  • Specifics of it (description)
  • What can happen between periods?
  • How can it affect periods?
A

Abnormal uterine bleeding
•Abnormal uterine bleeding refers to uterine bleeding outside of the parameters noted below :
– Duration greater than eight days
– Flow greater than 80 mL/cycle or subjective impression of heavier-than-normal flow
– Occur more frequently than every 24 days or less frequently than every 38 days
– Intermenstrual bleeding or postcoital spotting
– Absence of menses

17
Q

Abnormal uterine bleeding - different classifications

  • Duraction of symptoms
  • Underlying cause (way of remembering…)
  • Types of symptoms
A
18
Q

Abnormal uterine bleeding - fibroids

  • What are fibroids
  • Formation is driven by…
  • Complications…
A
19
Q

Abnormal uterine bleeding - Dysfunctional Uterine Bleeding (DUB)

  • What is this?
  • Subdivided into…
  • Explainations of it…
A
20
Q

Dysmenorrhea

  • What is this?
  • Common?
  • Presentation?
A
21
Q

Dysmenorrhea - Endometriosis

  • What is this?
  • Prevalence?
  • Risk factors?
  • Key hormone involved…
  • Symptoms it can cause…
A
22
Q

Dysmenorrhea - Endometriosis cont.

  • Reason for it?
  • Most common sites?
A

Endometriosis can occur anywhere in the body e.g. thorax, eyes, nose

23
Q

Dysmenorrhea - Management

Impact of menstrual disorders

A

Impact:
• Physical
• Psychological
• Social
• Studies/Work
• Quality of life
• These all need to be kept in mind and taken into account
during assessment and management