Common Menstrual Disorders
Amenorrhea Dysmenorrhea Dysfunctional uterine bleeding (DUB) Premenstrual syndrome Premenstrual dysphoric disorder Endometriosis
Common Women’s Reproductive disorders
Menstrual disorder Infertility Contraception Abortion Menopause
Amenorrhea
Absence of menses during reproductive years
Primary and Secondary Amenorrhea
Primary Amenorrhea
Absence of menses by age 14 with absence of development of secondary sexual characteristics or
Absence of menses by age 16 with normal development of secondary sexual characteristics
Secondary Amenorrhea
Absence of menses after a previous menstrual cycles
Dysmenorrhea
Painful menstruation
Primary and secondary
Primary Dysmenorrhea
increased prostaglandin production
Secondary Dysmenorrhea
Pelvic or uterine pathology
Surgery pain
Endometriosis is the most common cause
Dysfunctional Uterine Bleeding
Similar to and may overlap with other uterine bleeding disorders
- most often at the beginning and end of menstrual cycle
- hormonal disturbance
- treat underlying cause
Premenstrual Syndrome
a constellation of recurrent symptoms that occur during the luteal phase or last half of the menstrual cycle and resolve with the onset of menstruation
What is a more serious form of PMS?
Premenstrual dysphoric disorder (PMDD)
Symptoms of PMS/PMDD (ACDHO)
A-anxiety C-craving D-depression H-hydration O-other
How many symptoms must be present to be diagnosed with PMS and PMDD?
PMS-at least 1 during the 5 days before menses in each of the three previous cycles
PMDD-at least 5 and must occur during the week before and a few days after the onset of menstruation
Endometriosis
bits of functioning endometrial tissue are located outside of their normal site, the uterine cavity
Primary Infertility
the inability to conceive a child after 1 year of regular sexual intercourse unprotected by contraception
Secondary Infertility
the inability to conceive after a previous pregnancy
Male Factor Assessment for infertility
semen analysis, sexual characteristics, external and internal reproductive organ examination, digital prostate examination
Female Infertility Factor assessment
ovarian function pelvic organs
Laboratory and diagnostic testing for infertility
- Home ovulation predictor kits
- Clomiphene citrate challenge test
- Hysterosalpingogram
- Laparoscopy
Risk factors for Amenorrhea
menstrual history, past illnesses, hospitalizations, surgeries, obstetric history, use of prescriptions, lifestyle changes, present illnesses
Risk factors for Endometriosis
family history, short menstrual cycle, long menstrual flow, high fat consumption, young age of menarche, few or no pregnancies
Contraception BEHAVIORAL Methods
- Abstinence
- Fertility awareness
- Withdrawal
- Lactational amenorrhea method
How can a woman have fertility awareness?
- Cervical mucous ovulation method
- Basal body temperature
- Symptothermal method
- Standard days method
Contraception BARRIER Method
- Condoms
- Diaphragm
- Cervical cap
- Contraceptive sponge
Contraception HORMONAL Method
- Oral contraceptive
- Injectable contraceptives
- Transdermal patches
- Vaginal rings
- Implantable contraceptives
- Intrauterine contraceptives
- Emergency contraception
Contraception STERILIZATION
- Tubal ligation
- Vasectomy
Tubal ligation
Sterilization for women
-a laparoscope is inserted; fallopian tubes are grasped and sealed
Vasectomy
Sterilization for men
- Local anesthetic
- Involves cutting the vas deferens, which carries the sperm
What is the gold standard for assessing patency of the fallopian tubes?
Hysterosalpingography
Surgical Abortion
two types of surgical abortion: vacuum aspiration or dilation and evacuation
Medical Abortion
achieved through administration of medication either vaginally or orally
Menopausal Transition
transition from a woman’s reproductive phase of her life to her final menstrual period
Menopause and the Brain
hot flashes, sleep, mood, and memory problems
Menopause and the Heart
lower levels of HDL; increased risk of CVD
Menopause and Bones
bone density loss; increased risk of osteoporosis
Menopause and Breasts
duct and gland tissues replaced by fat
Menopause and Genitourinary
vaginal dryness, stress incontinence, cystitis
Menopause and GI
less Ca+ absorbed; increased fractures
Menopause and Skin
skin dry, thin; collagen decreases
Abortion
the expulsion of an embryo or fetus before it is viable
-medical or surgical
Sexual Abstinence
not having vaginal or anal intercourse
-least expensive form of contraception
Fertility awareness
any natural contraceptive method that does not require hormones, pharmaceutical compounds, physical barriers, or surgery to prevent pregnancy
-use physical signs and symptoms
Cervical Mucous Ovulation Method
Used to assess the character of cervical mucous
-the woman becomes aware of her bodies changes that accompany ovulation and she abstains from sexual intercourse or uses other methods to prevent pregnancy
Basal Body Temperature
the lowest temperature reached on awakening
- temp rises 1-2 days after ovulation
- woman avoids sex until the BBT has been elevated for 3 days
Withdrawal “Coitus Interruptus”
a man controls his ejaculation during sexual intercourse and ejaculates outside the vagina
-least effective
Diaphragm
soft latex dome surrounded by a metal spring
- inserted into the vagina to cover the cervix
- inserted up to 4 hours before intercourse but must be left in place for at least 6 hours after
Cervical cap
smaller than the diaphragm and covers only the cervix; held in place by suction
Contraceptive Sponge
nonhormonal, nonprescription device that includes both a barrier and a spermicide
- covers the cervix and releases spermicide
- inserted 24 hours before intercourse and up to 6 hours after intercourse
Vaginal Ring
contains both estrogen and progesterone hormones
-flexible, soft, transparent ring that is inserted by the user for a 3 week period followed by a ring free week to allow withdrawal bleeding
Transdermal patch
delivers continuous flow of estrogen and progesterone absorbed through the skin
-applied for 3 weeks followed by a week free period to allow bleeding
Intrauterine Contraceptives
hormonal or nonhormonal
- prevents pregnancy via inhibition of sperm mobility and viability and change the speed of transport of the ovum in the fallopian tube
- small plastic and T-shaped
Emergency Contraception
reduces the risk of pregnancy after unprotected intercourse or contraceptive failure
-used within 72 hours
Essure
nonsurgical, nonhormonal, permanent birth control method
- for women who do not wish to have more children
- released into the fallopian tubes through the cervix and promotes tissue growth eventually blocking the tubes (3 months)
