Menstrual cycle disorders menopause Malignant disorders of the reproductive tract

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foxyt14
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Menstrual cycle disorders menopause Malignant disorders of the reproductive tract
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2014-05-15 12:36:14
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Final stuff for OB
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  1. menstruation
    periodic shedding of endometrium with no conception
  2. menarche
    onset of menses...usually 11-14 yo
  3. Peri-menopause
    period of a woman's life characterized by physiological changes associated with the end of reproductive capacity and terminating with the completion of menopause
  4. Menopause
    • permanent cessation of menses (avg age 50-51)
    • aka climacteric
  5. Amenorrhea
    absence of menstruation
  6. when is amenorrhea normal
    • before the onset of menarche
    • during prego
    • puerperium
    • lactation
    • after menopause
  7. Primary Amenorrhea
    • failure to menstruate:
    • by 16 if have breasts/hair
    • by 14 with no hair/breasts
    • within 2 yrs of breast/hair development
  8. Causes of Amenorrhea
    • Turners Syndrome
    • Anatomic causes
    • Ovarian disorders
    • Hx of anorexia/bulimia
  9. How do you treat amenorrhea?
    • see an endocrinologist
    • counseling for eating disorder
    • hormone therapy
    • if unfixable due to reproductive tract or congenital anomalies...psych support
  10. Secondary Amenorrhea
    cessation of menstruation for 6 months or more in a woman who had a previously established menstruation pattern
  11. What happens if a person has lots of androgen hormone?

    s/s
    test them for polycystic ovarian syndrome

    • acne
    • excess weight and body hair
    • anovulation
  12. Menorrhagia
    excessive/prolonged menstrual flow that occurs irregularly

    *complications of an unrecognized pregnancy and spontaneous abortion must be considered when making the dx
  13. Metrorrhagia
    Inter-cyclic bleeding
  14. Menometrorrhagia
    Irregular and excessiver uterin bleeding
  15. When should a woman be checked for uterine cancer?
    when he is post menopausal and has vaginal bleeding
  16. How do you manage abnormal uterine bleeding?
    • prego test
    • coagulation studies
    • LFT
    • US
    • Hormones
    • Laparoscopy
    • D&C
  17. Dysmenorrhea
    painful menstruation
  18. S/S of dysmenorrhea
    • colicky spasmodic pain associated with menstruation
    • felt in lower abdomen
    • intensifies with stress
    • intensifies with IUD
  19. How do you treat dysmenorrhea?
    • rest
    • heat
    • distraction
    • exercise
    • analgesia
    • anti prostaglandins
    • birth control pills
  20. What's endometriosis?
    endometrial tissue found outside the uterus
  21. S/S of endometriosis
    • Dyspareunia (painful sex)
    • rectal pain with defection
    • endometrial tissue visualized right before period with vaginal exam
  22. Therapeutic management of PMS
    • zoloft
    • xanax
    • oral contraceptives
  23. Education for PMS
    • discourage self dx based on 1-2 symptoms....go see HCP
    • take multi vitamins
    • exercise
    • eat healthy
    • sleep good
    • don't smoke
    • BCP
  24. PMS person should take a multi vitamin with
    • 400mcg of folic acid
    • calcium
    • vitamin D
  25. Foods to avoid if have PMS
    salty/sugary
  26. Pain relief if have PMS
    NSAIDS...decrease prostaglandin production
  27. Prescribed med for person with PMS
    BCP...prevents ovulation
  28. Patient education for a woman with PMS
    help them to learn the predictable pattern of their symptoms so they can gain a sense of control over them....this can help diminish the symptoms
  29. S/S of menopause
    • amenorrhea
    • vasomotor instability
    • atrophic changes of genitalia
    • dyspareunia
    • urinary changes (frequency/incontinence)
    • constipation
    • decrease in bone density
    • skin changes
  30. Psych S/S of menopause
    • depression
    • mood swings
    • irritable
    • headache
    • insomnia
    • fatigue
    • loss of libido
    • forgetfulness
  31. Hormone replacement therapy risks for menopausal women
    • increases risk for
    • breast cancer
    • heart disease
    • stroke
  32. Two types of HRT for menopausal women
    • estrogen alone if they don't have a uterus
    • estrogen and progesterone if they have a uterus
  33. Why does a woman on HRT who has a uterus receive both estrogen and progesterone?
    cuz she needs cyclical shedding of her uterus or abnormal build up of endometrium will occur, causing risk for uterine cancer
  34. Risks of HRT
    • pulmonary embolism
    • endometrial cancer
    • breast cancer
    • coronary heart disease
    • stroke
  35. Contraindications for HRT therapy
    • seizure disorders
    • high levels of triglycerides and lipids
    • migraines
    • gallbladder disease
  36. Alternatives to ERT for symptom relief only
    • vitamin E/Ginseng
    • herbs
    • kegels
    • vaginal lubricants
    • good hydration
  37. Dealing with Menopause symptoms without hormones.....
    • cool hot flashes
    • optimize sleep
    • eat well
    • don't smoke
    • exercise regularly
  38. Complications of menopause
    • osteoporosis
    • dysfunction of pelvic floor
  39. When does PMS occur?
    Phase II....Luteal Phase
  40. Cardinal symptom of uterine cancer
    abnormal vaginal bleeding, pre or post menopause
  41. How do you dx uterine cancer?
    • endometrial biopsy to detect hyperplasia
    • D&C
  42. #1 risk factor for getting Cervical Cancer
    HPV
  43. How do you dx or screen for cervical cancer?
    Pap Smear every 3 years.....looking for a change in cells
  44. S/S of ovarian cancer
    • bowel/bladder complaints
    • feeling of fullness
    • early satiety
  45. Who is at risk for getting ovarian cancer
    white women who haven't had children, or have them late in life
  46. How do you screen for ovarian cancer?
    • bimanual exam
    • or
    • US to look for fluid filled cysts vs. solid tumors

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