Menstrual disorders Flashcards
(22 cards)
Hormonal control in follicular phase of cycle?
FSH stimlates follicle development and granulosa cells to produce oestrogens
Increasing oestrogens by dominant follicle inhibits FSH
Causes atresia
Hormonal control in ovulation phase?
LH surge
Dominant follicle ruptures and releases oocyte
Hormonal control in Luteal phase?
Formation of corpus luteum
Progesterone production
Luteolysis 14 days post ovulation
Hormonal control in proliferative phase?
Oestrogen induced growth of endometrial glands and strome
Physiological events in menstruation?
Arteriolar constriction and shedding of functional endometrial layer
Fibrinolysois inhibits scar tissue formation
How long does menstrual bleeding last?
4-6 days
How long is a normal menstrual cycle?
28 days average
Menorrhagia?
Prolonged and increased menstrual flow
Metrorrhagia?
Regular intermenstrual bleeding
Polymenorrhoea?
Menses occuring <21 day interval
Polymenorrhagia?
Increased bleeding and frequent cycle
Menometrorrhagia?
Prolonged menses and intermenstrual bleeding
Amenorrhoea?
Absence of menstruation > 6 months
Oligomenorrhoea?
Menses at intervals of >35 days
Local causes of organic menorrhagia?
Fibroids Malignancy Polyps Endometrial hyperplasia PID Endometriosis Trauma etc etc
Systemic causes of organic menorrhagia?
Endocrine eg Thyroidism, DM, adrenal disease
Haemostasis eg VWD
Liver
Renal
Drugs eg Anticoag
Causes of organic menorrhagia in pregnancy?
Misscarriage
Ectopic
What is DUB?
Dysfunctional uterine bleeding
Diagnosis by exclusion
Cause of ovulatory DUB
Corpus luteum not producing sufficient progesterone
investigations for DUB?
FBC Smear TSH Coag screen LFT/U and E Transvaginal US Endometrial sampling
Non surgical management of DUB?
OCP
NSAID
Danazol
GnRH analogue
Progsterone releasing IUCD
Surgical management of DUB
Endometrial resection/ablation
Hysterectomy
