Session 3 - Menstrual dysfunction Flashcards Preview

Semester 4 - Reproductive System > Session 3 - Menstrual dysfunction > Flashcards

Flashcards in Session 3 - Menstrual dysfunction Deck (31)
1

What is the average blood loss during a period?

30-45 ml

2

What is amenorrhoea?

Absence of periods for at least 6 months

3

What two categories is amonerrhoea split into?

Primary and secondary

4

What is pirmary amenorrhoea?

Never had a period. Absence of menses by age 14 with absence of secondary sexual charateristics/ absence by age 16 with normal SSC

5

What is secondary amenorrhoea?

Established menstruation has ceased for 3 months in a woman with a history of regular cyclic bleeding, or nine months in a woman with a history of irregular periods. Normally in a women age 40-55.

6

What is oligomoenorrhea?

Infrequent periods occuring at intervals of 35 days - 6 months

7

What is dysmenorrhoea?

Painful periods

8

What is menorrhagia?

Heavy periods. (Excessive (>80ml), prolonged (> 7 days) uterine bleeding

9

What is cryptomenorrhoea?

Periods occur but not visible due to obstruction in outflow tract

10

What is pre-menstrual syndrome?

Collection of emotional symptoms, with or without physical symptoms related to a woman's menstrual cycle

11

What is dysfunction uterine bleed?

Abnormal bleeding, no obvious organic cause

12

What is an anovulatory cycle?

No ovulation/luteal phase, oligo/amenorrhoea +/- mennorrhagia

13

What are ovulatory cycles?

Normal menstrual cycle + dysmenorrhea/mastalgia

14

What is the origin of primary ammenorhea?

Origin is hypothalamic/pituitary, ovarian or outflow tract

15

What is hypothalamic/pituitary amenorrhoea?

Inadequate levels of FSH lead to inadequately stimulated ovaries, which then fail to produce enough oestrogen to stimulate the endometrium of the uterus, giving amenorrhoea.

16

Give a cause of primary hypothalamic amenorrhoea?

Kallmann syndrome - Inability to produce GnRH

17

Give three causes of secondary hypothalamic ammenorhea

 Exercise Amenorrhoea – Related to physical exercise
 Stress Amenorrhoea
 Eating disorders and weight loss (Obesity, anorexia or bulimia). Fall below critical weight of 47kg menses will cease (see above).

18

Give three causes of secondary pituitary amenorrhoea?

Sheehan syndrome - Hypopituitarism
 Hyperprolactinaemia
 Haemochromatosis – ‘Iron overload’

Hypo/hyperthyroidism

19

What is ovarian amenorrhoea?

In Ovarian Amenorrhoea the ovary does not respond to pituitary stimulation, giving low oestrogen levels. The lack of –‘ve feedback from oestrogen leads to elevated FSH levels in the menopausal range (Hypergonadotrophic amenorrhoea).

20

Give four causes of primary gonadal/end-organ amenorrhoea?

 Gonadal dysgenesis – E.g. Turner Syndrome (45, X)
 Androgen Insensitivity Syndrome
 Receptor abnormalities for FSH and LH
 Specific forms of congenital adrenal hyperplasia

21

Give five causes of secondary gonadal/end-organ amenorrhoea?

 Pregnancy
 Anovulation
 Menopause (Or premature menopause)
 Polycystic Ovarian Syndrome
 Drug-induced

22

What is normal in amenorrhoea of outflow tract origin?

The hypothalamic-pituitary-ovarian axis

23

What is primary outflow tract obstruction? (Two causes?

 Uterine – Mullerian agenesis. 15% of primary amenorrhoea
 Vaginal – Vaginal atresia, cryptomenorrhoea, imperforate hymen

24

Give a cause of secondary outflow tract obstruction

 Intrauterine Adhesions (Asherman’s syndrome)

25

What must be looked at in the histroy of someone with secondary amenorrhoea?

o Menstrual history
 Ever had one before? What was your cycle like before?
o Contraception
o Pregnancy
o Surgery
o Medication
o Weight change
o Chronic diseases, stress, diet
o Family history
 Age at menopause, thyroid dysfunction, diabetes, cancer

26

Give parts of physical evaluation of secondary amenorrhoea

 BMI – Weight change
 Hair distribution – PCOS
 Thyroid
 Visual fields / Breast discharge – Hyperprolactinaemia
 Abdomen-masses? Tenderness?

27

Give two potential treatments for amenorrhoea

Hormon replacement, if due to hormone insufficiency
Lifestyle change, if due to lifestyle (exercise, weight loss)

28

What is dysfunctional uterine bleeding?

The corpus luteum does not form to release progesterone. As a result oestrogen is produced continuously, causing overgrowth of the uterine bleeding and subsequent bleeding.

29

What is menorrhagia?

Menorrhagia is heavy vaginal bleeding that is not DUB. It is usually secondary to distortion of the uterine cavity, leaving the uterus unable to contract down on open venous sinuses in the zona basalis.

30

Give four causes, other than distortion of the uterine cavity, that can cause menorrhagia?

Organic
Endocrine
Haemostatic
Iatrogenic

31

What are the two main actions one must do when menorrhagia is suspected?

Take history
Take full blood count