problems Flashcards
(26 cards)
what defines precocious puberty
girls <8
boys <9
what defines delayed puberty
13(breast)15 (menstruation),
14 in boys
what is menorrhagia & its causes
heavy periods >80ml/month, idiopathic, IUD, menopause, PCOS, blood thinning medication.
average age of menopause
51
what age is premature ovarian insufficiency
less than 40
what is dysmenorrhoea
pain during menstruation
what is primary dysmenorrhoea
where there is no associated cause
at what age is primary dys most common
teens-20s
symptoms of primary dysmenorrhoea
- gi symptoms and
- cramping - may radiate to thighs and back
- headaches/ fatigue
what is secondary dysmenorrhoea
consequence of other pelvic pathology
at what age is secondary dys most common
30s-40s
when do symptoms start in secondary dysmenorrhea
before menstruation
causes of primary
progesterone withdrawal = production of aa = precursor to prostaglandins
- higher conc of prostaglandins in menstrual fluid = vasoconstriction and myometrial hypoxia and contractility.
- endothelins in endothelium have a role in prostaglandin synthesis.
- vasopressin stimulates uterine activity
management of primary
NSAIDS
OTC- feminax express
Oral contraceptive pil - lnhibits ovulation
antispasmodics - unlisenced oTc
causes of secondary
endometriosis, menorrhagia, fibroids
management of secondary
surgery-ablation
pain relief
what is endometriosis
endometrial tissue found outside the uterus e.g. GI tract, urinary tract
cause of endometriosis
retrograde menstruation
symptoms of endometriosis
pain, fatigue, sub fertility, dyspareunia, dyschezia, dysuria, chronic pelvic pain and menstrual irregularities
diagnosing endometriosis
pelvic exam, ultrasound
diagnosis stange 1-2 endometriosis
minimal/mild
poor visual on us
implant in uterine and ovarian
diagnosis stage 3-4 endometriosis
mod to severe
associated with adhesions
bowl invasion
management of endometriosis
- surgical treatment - laparoscopy or hysterectomy
- medical treatment-symptomatic relief : 1st NSAIDS 2nd shrinkers e.g. contraceptives, GnRH analogues e.g. BUSERELIN
danger symptoms of menorrhagia
irregular bleeding, sudden change in blood loss, dyspareunia, pelvic pain, premenstrual pain
