reproductive Flashcards
(58 cards)
describe dysfunctional bleeding
abnormal uterine bleeding that occurs less than 21 days or >36 days or in
excessive amounts w/clots lasting > 7 days
with dysfunctional bleeding what must be ruled out
anatomical endometrial lesion must be ruled out
Ovulatory bleeding
Normal variant - “migelschmertz”
Normal (23-39 days {mean 29}, 2-7 days w/most blood loss in 1st few days)
Menorrhagia (normal in timing, excessive in amount &duration)
Intermenstrual (occurs between regular menses)
Ovulatory bleeding causes
fibroids Ca of the cervix endometrial Ca polyps, erosions , infection foreign bodies
what is anovulatory
disturbance w/in hypothalamic- pituitary-ovarian axis
when can you see an anovulatory state
Seen typically w/mild dysfunc;on of above w/irregular menses from situa-onal stress, wt. loss, exercise training
PCOs Presents
Irregularperiods:oligomenorrhea(<9menses/yr)oramenorrhea(nomensesfor3or
more consecu;ve months) infer;lity
Physical signs of PCOs
Hirsutism, obesity, amenorrhea, acne, DUB, Acanthosis Nigricans, HTN
Ovarian androgen overproduc;on is linked to
insulin resistance
Complications of PCOs
ncreased risk of T2DM r/t obesity, insulin resistance, impaired glucose tolerance,& dyslipidemia predispose to CHD
Nonalcoholic steatohepatitis
Mood disorders (depression & anxiety)
diagnostic test for ovulation evaluation
FSH (>40 ovarian failure),
LH, Prolactin,
serum progesterone,
testosterone
S/S of Menorrhagia
H/o prolonged heavy menses > 7 days •
Usual cycle interval
S/S Intermentstrual Bleeding:
mid cycle bleeding that is unpredictable • Regular ovulatory menses
s/s of Anovulatory Bleeding:
Menstruation that occurs without ovulation
Evidence of hyperandrogenemia –
Body build, hair distribution
Diagnostic labs with annovulatory bleeding
evaluation – B-hCG – CBC – Thyroid, prolac;n, cortisol – Testosterone – Endometrial Bx- >35, severely obese, abn. blg >5 yrs
s/s of Amenorrhea
absence of menstrual bleeding
Types of Ammenorrhea
Primary-
– No bleeding by the age of 14 in the absence of 2nd sex characteristics
no bleeding by age 16 regardless of the presence of normal G & D w/ 2nd sex characteristics
Secondary- previously menstruating & misses 3 cycles
Primary Ammenorhea is due to
result of gene;c disorders or premature loss of follicles
secondary Ammenorhea is due to
Secondary- lack of gonadatropin s;mula;on to normal ovaries
ammenorheia is associated with
elevated prolactin and galactorrhea.
Menopause is
Permanent cessa;on of menstrua;on following the decline of
ovarian estrogen production
Peri-menopause is
the period extending from immediately before to after the menopause (45-55 yrs), transi;on lasts 4 years, marked by altered ovarian functi on
S/S of menopause
irregular menses, hot flashes, dyspareunia r/t vaginal dryness, night sweats, dry skin or hair, joint stiffness, urinary changes, H/A, irritability, insomnia, depression, loss of sense of well being,
Diagnostic test for menopause is
Pap smear: – Endometrial bx – Mammogram yearly after 40 – Cholesterol baseline data rpt q 5 yrs – BS – baseline data – TSH, T4 – Prolactin , FSH – Pregnancy test – FOB annual exam for women>40 – Sigmoidoscopy q 5 yrs after 50
