Menstrual problems Flashcards Preview

The Patient (Y3-1) > Menstrual problems > Flashcards

Flashcards in Menstrual problems Deck (17)
Loading flashcards...
1

Define amenorrhoea

Absence of periods

2

Define oligomenorrhoea

Infrequent periods

3

Define polymenorrhoea

Menstrual cycle that is shorter than 21 days

4

Define menorrhagia

Heavy flow in period

5

Outline the pathophysiology of dysmenorrhoea

Cell wall of phospholipids are converted to arachidonic acid by phospholipase. This ends up being one of two precursors: leukotrienes or cyclic endoperoxides
This whole process and production of phospholipase is triggered by withdrawal of progesterone at end of menstrual cycle

6

How is endometriosis diagnosed?

Pelvic exam
Pelvic ultrasound
Diagnostic laparoscopy

7

What's the difference between primary and secondary dysmenorrhoea?

Primary - peak incidence teens to twenties - secondary peak incidence thirties to forties
Secondary is a consequence of other pelvic pathology

8

How can primary dysmenorrhoea be managed pharmacologically?

NSAIDs
OTC - feminax
Oral contraceptive pill
Antispasmodics e.g. hyoscine butylbromide

9

What is primary dysmenorrhoea caused by?

Pain due to higher concentrations of prostaglandins in menstrual fluid

10

What is secondary dysmenorrhoea caused by?

Pain due to prostaglandin involvement but also due to underlying pelvic pathology

11

How is secondary dysmenorrhoea managed pharmacologically?

Investigate and ascertain underlying cause and treat accordingly
Options include:
- surgery
- symptomatic relief

12

What is endometriosis?

Where endometrial tissue is found outside the uterus

13

How is endometriosis pharmacologically managed?

1st line - analgesia
2nd line - shrinkers to get rid of excess endometrial tissue

14

What type of shrinkers can be given for the management of endometriosis?

Contraceptives
Progestogens
Gonadotropin releasing hormone analogues
Anti-progestogens

15

What are the causes of menorrhagia?

Dysfunctional uterine bleeding
Other gynaecological causes - menopause, fibroids
Endocrine and haematological causes - PCOS, blood thinning meds

16

How is menorrhagia diagnosed?

Blood test
Cervical smear
Endometrial biopsy

17

How is menorrhagia pharmacologically managed?

If contraception is required - CHC, POC, IUS
If contraception not required - tranexamic acid, GnRH antagonists, oral progestogen (norethisterone), antiprogestogens