Menstruation Flashcards
(19 cards)
What is menorrhagia?
Prolonged (7d+) or excessive (80mLs+ per cycle) occurring at regular intervals
Average blood loss per menstrual cycle?
35mLs per cycle
What is metrorrhagia?
Irregular cycle and more frequent
What is menometrorrhagia?
Prolonged or excessive bleeding occurring at irregular and more frequent intervals
What is metros taxis?
Acute, very heavy bleed
Ddx of vaginal bleeding?
AUB
Systemic: endocrine, bleeding disorders, liver disease)
Adenomyosis
Fibroids
Polyps
Inection
Carcinoma
Iatrogenic
Pregnancy
What are the uterine and local causes of AUB?
Myometrium: fibroids, adenomyosis
Endometrium: polyps, hyperplasia, carcima, endometritis, IUD
Cervix: polyps, Ca
Ovarian pathology
RFx for fibroids?
Nulliparity
Obesity
+ve FHx
Symptoms of fibroids?
Mostly asymptomatic
Pressure
Frequency (urinary)
Menstrual disturbance
Pregnancy issues
Pain: if necrosis, torsion
What is adenomyosis?
Endometrial glands within myometrium
CFx of adenomyosis?
Multiparous; 30s/40s
Menorrhagia
Dysmenorrhoea
Bulky, tender uterus
Ix (Imaging) of choice in adenomyosis diagnosis?
MRI
USS is insensitive
Mx (Management) adenomyosis?
Induce amenorrhoea with hormonal treatment
GnRH analogues
Mirena
Hysterectomy
Iatrogenic causes of AUB?
OCP
Depot provera
Implanon
IUD
Anticoagulation
Chemotherapy (thrombocytopenia)
Bimanual exam features of adenomyosis?
Large, tender, globular uterus
Medical Mx of HMB (heavy menstrual bleeding)?
Treat cause
A. Non Hormonal: PG inhibitors, anti-fibrinolytics
B. Hormonal: OCP, depot provera, GnRH analogues
C. Procedural: Mirena
Most common cause of teenagers with HMB?
Anovulatory DUB (80% ovulatory 3y after menarche)
Hx to elicit when evlaluating HMB?
Age
Parity
LNMP and ?preg
frequency / vol / pattern
Impact on QoL
Comorbidities (diabetes, obesity, PCOS, thyroid disease, bleeding disorders)
Pelvic pain or pressure
Fhx: endometriosis, endometrial or bowel cancer
