Menstrual Cycle, Problems and Vaginal Bleeding

Question 1

Endometriosis

Management

Answer 1

Pain - hot water bottles, Ponstan, paracetamol, etc.
COCP - can skip sugar tablets every 1-2 cycles
Depot Provera (GNRH analogue)
Laparoscopy - remove bits of endometriosis, cysts and adhesions
Radical hysterectomy and bilateral salpingoophrectomy

Question 2

Asherman’s

Answer 2

Irregular spotting in someone with PHx of D&C

Question 3

PCOS

Answer 3

Primary infertility

Fullness in both adnexae

Question 4

Prolactinoma

Answer 4

Secondary amenorrhoea, frequent headaches, nipple discharge

Question 5

Premature ovarian failure

Answer 5

<40

Low oestrogen, high 3 day FSH

Question 6

Adenomyosis

Answer 6

Older age (~40)
Dysmenorrhoea and menorrhagia
Glandular tissue found in the myometrium of the uterus

Question 7

Fibroid uterus

Answer 7

Menorrhagia and intermenstrual bleeding

Palpable large mass in midline suprapubic region that is fixed

Question 8

Benign ovarian tumour

Answer 8

Irregular periods
Mass in adnexa
No hepatosplenomegaly or ascites

Question 9

HCG

Answer 9

Used in IVF to induce ovulation

Question 10

Testosterone

Answer 10

Produced by Leydig cells

Question 11

Estradiol

Answer 11

Low during menopause