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MD3002 post MSA > menstrual disorders > Flashcards

menstrual disorders Flashcards

1
Q

what part of the brain controls menarche

A

hypothalamus control due to GNRH pulsatility

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2
Q

what is the mean age of menopause

A

51 years

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3
Q

what causes thickening of the endometrium

A

oestrogen

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4
Q

what are the features of the menstrual phase

A

3-5 days
period
part of follicular phase

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5
Q

what are the features of the proliferative phase

A 
period stops 
oestrogen causes endometrium to thicken 
myometrium grows
synthesis of progesterone receptors
10 days 
part of follicular phase 
dominant hormone is estradiol 17b
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6
Q

what is the histology of the proliferative phase

A

repair of epithelia
proliferation of stroma
test tube shaped glands
synthesis of intracellular receptors for progesterone
contractility of the myometrium increases

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7
Q

what are the features of the secretory phase

A

begins after ovulation
endometrium increases secretory activity under influence of progesterone
endometrial glands become coiled and filled with glycogen, sugars and amino acids, angiogenesis- spiral arteries, enzymes accumulate
in order to accept an embryo
part of luteal phase
enlargement of myometrial cells but depressed excitability

12 days

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8
Q

what are the features of the ischaemic phase

A 
constriction of spiral arteries
ischaemia of endometrium 
separation of layers
functional layer is shed 
increase in neutrophils
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9
Q

how many menstrual cycles will the average woman have in a lifetime

A

450 if well nourished

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10
Q

what causes bleeding without clotting

A

endogenous fibronolytic activity

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11
Q

what is the average volume of menstrual blood lost

A

30- 80mls

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12
Q

why are oestrogen and progesterone low in the menstrual phase

A

corpus luteum is regressing

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13
Q

what hormones are high during the menstrual phase

A

FSH and LH- causes follicles to mature

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14
Q

when does a single follicle become dominant

A

day 7

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15
Q

what structure secretes oestrogen in order to stimulate proliferation of the endometrium

A

dominant follicle

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16
Q

why does LH and FSH decrease during the proliferative phase

A

oestrogen and inhibin negative feedback

this causes degeneration of non dominant follicles

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17
Q

what happens during day 12-13

A

LH surge induced by oestrogen

oocyte completes meiosis 1

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18
Q

what happens in day 14

A

ovulation mediated by follicular digestive enzymes and prostaglandins

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19
Q

what does the corpus luteum do

A

secretes oestrogen and progesterone
this develops the secretory endometrium
secreation of FSH and LH is inhibited so no new follicles develop

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20
Q

what causes sloughing of the endometrium

A

degeneration of the corpus luteum which causes drop in oestrogen adn progesterone

21
Q

how does the cervical mucus change during the proliferative phase

A

becomes penetrable by sperm

22
Q

what is oligomenorrhoea

A

infrequent light periods

23
Q

what is metrorrhagia

A

irregular bleeding

24
Q

what is dysmenorrhoea

A

painful periods

25
Q

what is polymenorrhoea

A

frequent periods

26
Q

what is amenorrhoea

A

no periods

27
Q

what causes heavy periods

A

imbalance of prostaglandin and thromboxane

treated with antifibrinolytic

28
Q

what causes dysmenorrhoea

A

too much prostaglandins produced by endometrium in response to decreased steroid hormones
excessive uterine contractions
this can also account for nausea, vomiting and headache

29
Q

what is PMS

A

cyclical symptoms which affect QOL

30
Q

what is PMDD

A

premenstrual dysphoric disorder

may be very disabling

31
Q

what does anxiolytic mean

A

reduces anxiety

32
Q

what might cause pms

A

falling levels of progesterone which is an anxiolytic

33
Q

what are the symptoms of PMS

A
  • anxiety
  • mood swings
  • :redness
  • irritability
  • depression
  • a loss in confidence
  • clumsiness
  • headaches
  • feeling bloated
  • a change in appe:te
  • joint pain
  • tender enlarged breasts
  • abdominal pain
34
Q

what are the primary causes of amenorrhoea

A

anatomical/ congenital
eg absence of uterus/vagina
or genetic e.g. turners, AIS, other intersex conditions

35
Q

what are secondary causes of amenorrhoea

A 
pregnancy 
lactation 
exercise and nutrition 
menopause
PCOS
iatrogenic 
hormonal contraceptives
36
Q

what are the symptoms of eostrogen deficiency

A

hot flushes, vaginal dryness
loss of bone mineralisation
reduction in bone mass

37
Q

why does lactation cause amenorhoea

A

to stop the mother getting pregnant temporarily to increase survival chance of the infant -metabolic cost

38
Q

what are the possible symptoms of PCOS

A 
• hyperandrogenemia
• oligomenorrhea
• obesity – depends on the ethnicity of women
• hirsutism
• infertility
• enlarged cystic ovaries
acne 
amenorrhoea
39
Q

what are the features of PCOS

A

elevated oestrogen and testosterone and anti mullerian hormone
insulin resistance
on ultrasound- black cysts can be seen

40
Q

how is PCOS treated

A 
weight control
oral contraceptive to regulate cycle
anti androgens
hair removal
ovulation induction
41
Q

where is prolactin released

A

anterior pituritary gland

42
Q

what controls prolacitn

A

hypothalamic prolactin inhibitory factor (PIF)- dopamine

43
Q

how does stress affect dopamine

A

inhibits dopamine which allows prolactin levels to rise

44
Q

where is dopamine released

A

arcuate nucleus

45
Q

what is a pituritary tumour called

A

macroadenoma

46
Q

what are the effects of a pituritary tumour

A

prevents PIF reaching the anterior pituritary
this causes prolactin levels to rise
inhibits FSH and LH causing amenorrhoea
inapropriate lactation and loss of libido

47
Q

what are the features of menopause

A

lack of follicular development leading to low oestrogen and elevated FSH

48
Q

what can cause premature ovarian failure

A

idopathic, autoimmune, genetic e.g. fragile X, chemo, radiation

MD3002 post MSA (66 decks)

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