Flashcards in Lecture 6- Abnormal Bleeding Deck (44):
Frequent menstrual bleeding (<21 days)
Prolonged or excessive bleeding occuring at regular intervals (loss of 80mL or more lasting for more than 7 days).
Bleeding in between periods.
Frequent bleeding that is excessive and irregular in amount and duration.
what is the most common cause of amenorrhea?
What levels should be measured with amenorrhea?
FSH, LH, prolactin level
What is primary amenorrhea?
No menstruation by age 13 w/out 2° sexual development or by age 15 with 2° sexual development.
What is secondary amenorrhea?
Absence of menstruation for 3 – 6 months in a previously normal menstruating woman or for three typical cycle lengths in a woman with oligomenorrhea.
What are some functional causes of amenorrhea?
Wt loss, excessive exercise, obesity, drug-induced, neoplastic, psychogenic, heat injury, chronic medical illness
When is ovarian failure considered premature?
Women under 40
What are the most common anomalies in primary amenorrhea?
Absence of uterus or vagina
What is a syndrome that is from scarring of the uterine cavity due to D&C. Most frequent anatomic cause of secondary amenorrhea.
Asherman Syndrome (common in people with a number of abortions)
What is a common syndrome that causes anovulatory abnormal uterine bleeding?
What are the two main types of abnormal uterine bleeding?
What causes anovulatory AUB?
Endometrium outgrows its blood supply and sloughs at irregular and unpredictable times. Bleeding can be light and infrequent or frequent and heavy (can alternate)
What causes ovulatory AUB?
Luteal phase defect.
Corpus luteum doesn't develop fully.
There is insufficient progesterone secretion.
How long does the corpus luteum live?
What do you measure for ovulatory AUB?
Progesterone (often at day 21)
What tests do you do for AUB?
vaginitis/ STI screening
What are some risks associated with AUB?
Anemia, acute hemorrhage, endometrial hyperplasia/ CA
What is some treatment for AUB?
Prover 10 mg 10-14 days
high dose estrogen
OCP 4x4, 3x3, 2x2, 1 PO q day
If people with AUB has no reponse to medical thearpy what can be done?
Ablation of uterine lining
What is excess of protaglandins leading to painful uterine muscle cramping.
what is painful uterine muscle cramping caused by clinically identifiable causes: extrauterine, tumors, intramural, intrauterine.
What is the main difference b/w chronic pelvic pain and dysmenorrhea?
Chronic pelvic pain isn't cyclical, where dysmenorrhea is
What are some common cause of secondary dysmneorrhea?
Endometriosis, adenomyosis, adhesions, PID, leiomyomata
When is secondary dysmenorrhea most common?
Later in life
What are common therapy for primary dysmenorrhea?
NSAIDS (prostaglandin inhibitors)
What is used for cases of severe pain that don't respond to conventional therapy. This disrupts the presacral nerves.
How do you treat secondary dysmenorrhea?
Correct underlying condition when possible.
OCP can also be used
How long does pelvic pain need to have lastsed to be diagnosed as chronic pelvic pain?
Longer than a year
Is chronic pelvic pain just combined to the uterus?
No, can also involve diseases of reproductive, genitourinary, and GI tracts
What is a condition that can cause chronic pelvic pain and is a chronic inflammatory condition of the bladder?
Interstitial cystitis (ICS)
What is when there is the presence of endometrial glands and stroma in any extrauterine site
What do you use for diagnosis of endometriosis?
What are the three major theories of endometriosis?
1. Retrograde menstruation
2. Vascular and lymphatic dissemination
3. Coelomic metaplasia
What should you think when you see "mulberry, brown lesions, "chocolate cysts"
What is the triad of endometriosis?
Dysmenorrhea, dyspareunia, dyschezia
What are the two types of surgery for endometriosis?
Extirpative (everything removed)
What is medical treatment for endometriosis?
NSAIDS, continuous OCP’s, Depo-Provera, Danazol, GnRH agonists (Depo-Lupron) with add-back therapy.
What are benign muscular tumors or the uterus. Highest prevalence in 5th decade?
Uterine Leiomyomas (fibroids)
What type women have a higher prevalence of uterine fibroids?
What are the three most common types of leiomyomas?