PMS & PCOS Flashcards Preview

Gynaecology > PMS & PCOS > Flashcards

Flashcards in PMS & PCOS Deck (17):
1

What is premenstrual syndrome (PMS)?

Psychological, behavioural and physical symptoms that are experience on a regular basis during the luteal phase of the menstrual cycle and resolve by the end of menstruation

2

Common presentation of PMS?

*Mood swings
*Feeling upset, anxious or irritable
*Tiredness, or trouble sleeping
*Bloating, tummy pain
*Breast tenderness
*Headaches
*Spotty skin/greasy hair
*changes in appetite and sex drive

3

How is premenstrual syndrome diagnosed?

*Symptoms diary over 2 cycles
*GnRH analogues used is diary inconclusive

4

1st line management of PMS?

Lifestyle changes!
*Regular exercise
*Healthy balances diet
*Yoga/meditation
*Painkillers -ibuprofen/paracetamol
=all to reduce stress and pain

5

What medical treatments are there for PMS?

*Combined oral contraceptive pill
*CBT
*Antidepressant i.e. SSRIs
*Vitamin B6

6

What are the differentials for PMS?

*Depression
*Hyperthyroidism

7

What is polycystic ovarian syndrome?

Emcompasses a syndrome of polycystic ovaries, is association with systemic symptoms causing reproductive, metabolic and psychological disturbances

8

How does PCOS most commonly present?

*Infertility
*Amenorrhoea or oligomenorrhoea <9 periods a year
*Acne
*Hirsutism
*Obesity
*alopecia

9

How is PCOS diagnosed?

Using the rotterdam criteria, must have 2/3
*Polycystic ovaries
*olig-ovulation/anovulation
*clinical/biochemical signs of hyperandrogenism

10

What investigations are done in suspected PCOS?

*Pelvic ultrasound: multiple cysts on ovaries
*FSH, LH, prolactin, TSH and testosterone bloods
*Check for impaired glucose tolerance

11

What blood results will a woman with PCOS get back?

*Testosterone elevated
*FSH normal or low
*LH mey be elevated
*Prolactin normal or mildly elevated
*Glucose fasting may be elevated
*HbA1c may be elevated

12

What are the long-term complications of PCOS?

Association of
*Obesity
*dyslipidaemia
*insulin resistance type 2 diabetes
*increased risk of cardiovascular disease
*infertility
*oligomenorrhoea/amenorrhoea predispose to endometrial hyperplasia/carcinoma

13

What drugs in women with PCOS can be used to stimulate ovulation to help with fertility?

*Metformin
*Clomifene

14

What general management of PCOS should be done?

*weight reduction if appropriate
*combined oral contraceptive to help regulate cycle and induce monthly bleeds

15

What management in PCOS can help hirsutism and acne?

*combined oral contraceptive
*topical elflornithine

16

What management in PCOS can help infertility?

*weight reduction
*Metformin/clomifene used to stimulate ovulation

17

What are pregnant PCOS women more at risk of?

*Gestational diabetes
*pre-term birth
*pre-eclampsia