Menstrual Disorders

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  1. What is dysmenorrhea?
    Crampy pelvic pain starting shortly before or at onset of menses typically lasting 1-3d
  2. What sets PMDD apart from PMS?
    • At least 5 of the following must be present:
    • markedly depressed mood
    • marked anxiety
    • marked affective lability
    • marked anger or irritability
    • decreased interest in activities
    • fatigue
    • difficulty concentrating
    • changes in appetite
    • sleep disturbance
    • feelings of being overwhelmed
    • breast tenderness
    • bloating
    • One of the symptoms must be markedly depressed mood, anxiety, irritability, or affective lability
    • Sx interfere significantly with work and/or social relationships
  3. What is the tx for PMDD?
    • SSRI continual or luteal dosing (DOC)
    • Venlafaxine continual or luteal dosing
    • Clomipramine
    • Leuprolide
  4. What is the tx for dysmenorrhea?
    • NSAIDs (DOC, esp Naproxen and Ibuprofen)
    • OC
    • MPA depot or Levonorgestrel IUD
  5. What are the sx of endometriosis?
    • dyspareunia
    • chronic pelvic pain (cyclic or acyclic)
    • premenstrual spotting
    • GI or urinary disturbances
    • low back pain
    • painful defecation
    • infertility
    • cul-de-sac or uterosacral ligament tenderness
    • adnexal enlargement or tenderness
    • pelvic mass (lesions or cysts)
  6. What is the tx for endometriosis?
    • NSAIDs
    • Combination OCs
    • Progestins
    • Danazol
    • GnRH agonists (leuprolide)
  7. What are the monitoring parameters for clomiphene?
    • Basal body temp
    • Serum progesterone
    • Urinary LH
    • Follicular growth and endometrial thickness
    • Pregnancy test
  8. What are the SE of clomiphene?
    • Hot flashes
    • Mood swings
    • Visual disturbances
    • Breast tenderness
    • Pelvic discomfort
    • Nausea
    • Multiple gestations
    • Ovarian Hyperstimulation Syndrome (OHSS)
  9. When should clomiphene be started for infertility?
    Day 5 of the cycle
Card Set:
Menstrual Disorders

Menstrual Disorders
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