menstrual disorders Flashcards Preview

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Flashcards in menstrual disorders Deck (48):
1

what part of the brain controls menarche

hypothalamus control due to GNRH pulsatility

2

what is the mean age of menopause

51 years

3

what causes thickening of the endometrium

oestrogen

4

what are the features of the menstrual phase

3-5 days
period
part of follicular phase

5

what are the features of the proliferative phase

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

6

what is the histology of the proliferative phase

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

7

what are the features of the secretory phase

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

8

what are the features of the ischaemic phase

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

9

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

450 if well nourished

10

what causes bleeding without clotting

endogenous fibronolytic activity

11

what is the average volume of menstrual blood lost

30- 80mls

12

why are oestrogen and progesterone low in the menstrual phase

corpus luteum is regressing

13

what hormones are high during the menstrual phase

FSH and LH- causes follicles to mature

14

when does a single follicle become dominant

day 7

15

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

dominant follicle

16

why does LH and FSH decrease during the proliferative phase

oestrogen and inhibin negative feedback
this causes degeneration of non dominant follicles

17

what happens during day 12-13

LH surge induced by oestrogen
oocyte completes meiosis 1

18

what happens in day 14

ovulation mediated by follicular digestive enzymes and prostaglandins

19

what does the corpus luteum do

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

20

what causes sloughing of the endometrium

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

21

how does the cervical mucus change during the proliferative phase

becomes penetrable by sperm

22

what is oligomenorrhoea

infrequent light periods

23

what is metrorrhagia

irregular bleeding

24

what is dysmenorrhoea

painful periods

25

what is polymenorrhoea

frequent periods

26

what is amenorrhoea

no periods

27

what causes heavy periods

imbalance of prostaglandin and thromboxane
treated with antifibrinolytic

28

what causes dysmenorrhoea

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

what is PMS

cyclical symptoms which affect QOL

30

what is PMDD

premenstrual dysphoric disorder
may be very disabling

31

what does anxiolytic mean

reduces anxiety

32

what might cause pms

falling levels of progesterone which is an anxiolytic

33

what are the symptoms of PMS

• 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

what are the primary causes of amenorrhoea

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

35

what are secondary causes of amenorrhoea

pregnancy
lactation
exercise and nutrition
menopause
PCOS
iatrogenic
hormonal contraceptives

36

what are the symptoms of eostrogen deficiency

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

37

why does lactation cause amenorhoea

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

38

what are the possible symptoms of PCOS

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

39

what are the features of PCOS

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

40

how is PCOS treated

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

41

where is prolactin released

anterior pituritary gland

42

what controls prolacitn

hypothalamic prolactin inhibitory factor (PIF)- dopamine

43

how does stress affect dopamine

inhibits dopamine which allows prolactin levels to rise

44

where is dopamine released

arcuate nucleus

45

what is a pituritary tumour called

macroadenoma

46

what are the effects of a pituritary tumour

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

what are the features of menopause

lack of follicular development leading to low oestrogen and elevated FSH

48

what can cause premature ovarian failure

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