Menstrual disorders
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This document discusses menstrual disorders and provides information about normal menstrual cycles as well as common disorders. It describes that a normal menstrual cycle is typically between 20-40 days with bleeding lasting 2-7 days and average blood loss of 40cc. Common symptoms include cramps and feelings of unpleasantness due to hormonal withdrawal. Main disorders discussed are premenstrual syndrome (PMS), abnormal menstruation, and dysfunctional uterine bleeding (DUB). PMS occurs in the 4-5 days before a period due to water and electrolyte imbalance from estrogen. Abnormal menstruation encompasses conditions like menorrhagia and metrorrhagia. DUB results in excessive bleeding that is irregular in duration, amount and frequency
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Menstrual abnormalities
This document discusses various types of menstrual abnormalities including primary and secondary amenorrhea, dysmenorrhea, and other abnormalities of menstruation. Primary amenorrhea is defined as the absence of menses by age 14 without secondary sexual development or by age 16 with development. Causes include hypothalamic-pituitary issues, ovarian problems, or anatomical abnormalities. Secondary amenorrhea is defined as cessation of menstruation for 3 months or more and can be caused by pregnancy, menopause, diseases, drugs, or genetic disorders. Dysmenorrhea refers to painful periods and can be primary, caused by prostaglandins, or secondary, due to pelvic lesions. Investigations and management are
Dysfunctional uterine bleeding
Dysfunctional uterine bleeding (DUB) refers to abnormal uterine bleeding without an obvious medical cause. It can occur before or during a woman's reproductive years due to disorders of the hypothalamus-pituitary-ovary axis. DUB is categorized as anovulatory or ovulatory functional bleeding. Common symptoms include irregular, heavy, or painful periods. Diagnosis involves medical history, physical exam, and lab tests to rule out other causes. Treatment options depend on the type and severity of DUB but may include hormone therapy, birth control pills, or procedures like dilation and curettage.
Post menopausal bleeding
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Disorders of menstruation and disorders of the uterus
Disorders of menstruation p 499, p 486
PCCM p 180
• Dysmenorrhoea
o Primary PCCM p 180
Management p 499 / PCCM 180
o Secondary PCCM p 181
Causes
Clinical features
Management
• Premenstrual tension PCCM 185
o Clinical features
o Management
• Amenorrhoea PCCM p 181
o Primary p 181
Causes
Management
o Secondary p 181
Causes
Management
• Menorrhagia PCCM p 183
o Clinical features
o Causes
• Post menopausal bleeding
Essential health information
• Menopause PCCM p 182 / p 500,
• p 491
o Clinical features
o Management PCCM p 182 / nursing
o Essential health information p 500, 491
• Metrorrhagia PCCM p 183
o Causes
Disorders of the uterus p 508, p 498 / PCCM 196
• Endometriosis
o Pathophysiology (last paragraph)
o Risk factors
o Assessment and common findings / clinical features
o Management
Ovarian cysts p 512, p 503
• Pathophysiology
• Assessment & common findings
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Diagnostic tests p 527, p 519
• Mammogram
• Ultrasound
• Biopsy
Fibrocystic Breast p 529 , p 521
• Causes
• Pathophysiology
• Assessment and common findings
• Nursing management
Fibroadenoma p 529, p 521
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Breast cancer p 529, p 522
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• Assessment and common findings
• Management of breast cancer
• Surgical management
• Pre mastectomy management
• Post mastectomy management
• Post mastectomy exercises
• Reconstructive breast surgery
27.Amenorrhea
Amenorrhea is defined as the absence of menstruation. It can be primary, occurring before age 16, or secondary, occurring after menstruation has started. Possible causes of amenorrhea include issues with the hypothalamus, pituitary gland, ovaries, or uterus. Hypothalamic amenorrhea can be caused by stress, eating disorders, excessive exercise, or certain drugs. Evaluation of amenorrhea involves assessing sexual development, hormone levels, imaging tests, and response to medication challenges to determine the underlying cause. Treatment depends on the specific cause but may include hormone replacement, surgery, or lifestyle changes.
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Dysfunctional uterine bleeding (DUB) refers to abnormal uterine bleeding without an obvious medical cause. It can occur before or during a woman's reproductive years due to disorders of the hypothalamus-pituitary-ovary axis. DUB is categorized as anovulatory or ovulatory functional bleeding. Common symptoms include irregular, heavy, or painful periods. Diagnosis involves medical history, physical exam, and lab tests to rule out other causes. Treatment options depend on the type and severity of DUB but may include hormone therapy, birth control pills, or procedures like dilation and curettage.
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This document discusses postmenopausal bleeding, defined as any vaginal bleeding occurring more than 12 months after a woman's last menstrual period. The most common causes are atrophic vaginitis (60-80%), estrogen treatments (15-25%), and cervical or uterine polyps (2-12%). Evaluation involves obtaining a medical history, performing a clinical examination including a cervical smear and pelvic exam, and diagnostic testing such as ultrasound and endometrial biopsy. Treatment depends on the underlying cause, but may include hormone therapy for atrophic vaginitis or polyp removal, and in some cases of hyperplasia or cancer, hysterectomy.
Disorders of menstruation and disorders of the uterus
Disorders of menstruation p 499, p 486
PCCM p 180
• Dysmenorrhoea
o Primary PCCM p 180
Management p 499 / PCCM 180
o Secondary PCCM p 181
Causes
Clinical features
Management
• Premenstrual tension PCCM 185
o Clinical features
o Management
• Amenorrhoea PCCM p 181
o Primary p 181
Causes
Management
o Secondary p 181
Causes
Management
• Menorrhagia PCCM p 183
o Clinical features
o Causes
• Post menopausal bleeding
Essential health information
• Menopause PCCM p 182 / p 500,
• p 491
o Clinical features
o Management PCCM p 182 / nursing
o Essential health information p 500, 491
• Metrorrhagia PCCM p 183
o Causes
Disorders of the uterus p 508, p 498 / PCCM 196
• Endometriosis
o Pathophysiology (last paragraph)
o Risk factors
o Assessment and common findings / clinical features
o Management
Ovarian cysts p 512, p 503
• Pathophysiology
• Assessment & common findings
• Management
Diagnostic tests p 527, p 519
• Mammogram
• Ultrasound
• Biopsy
Fibrocystic Breast p 529 , p 521
• Causes
• Pathophysiology
• Assessment and common findings
• Nursing management
Fibroadenoma p 529, p 521
• Management
Breast cancer p 529, p 522
• Risk factors
• Assessment and common findings
• Management of breast cancer
• Surgical management
• Pre mastectomy management
• Post mastectomy management
• Post mastectomy exercises
• Reconstructive breast surgery
27.Amenorrhea
Amenorrhea is defined as the absence of menstruation. It can be primary, occurring before age 16, or secondary, occurring after menstruation has started. Possible causes of amenorrhea include issues with the hypothalamus, pituitary gland, ovaries, or uterus. Hypothalamic amenorrhea can be caused by stress, eating disorders, excessive exercise, or certain drugs. Evaluation of amenorrhea involves assessing sexual development, hormone levels, imaging tests, and response to medication challenges to determine the underlying cause. Treatment depends on the specific cause but may include hormone replacement, surgery, or lifestyle changes.
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Types of Menstrual disorders and there causes and symptoms
In this slide, you can understand the types of menstrual disorders, Mahvari or haiz.
You can learn about the types of Menstruation.
Types of Menstrual disorders.
cause of menstruation
symptoms of menstruation
diagnosis of menstruation
Treatment of menstruation bleeding
Heavy bleeding or menstrual cramps
Menstrual cycle
Amenorrhea
Dysmenorrhea
Oligo menorrhea
PMS (Premenstrual syndrome) or PMDD (Premenstrual dystrophic disease)
Menorrhagia
You can download Powerpoint of menstrual disorders here:
https://docs.google.com/presentation/d/1SCDUYcPYP7vpE4kzWoBwzYnyg4vzNAcXWrFp_iIZAnA/edit#slide=id.p1
You can download video from:
https://youtu.be/APWG2liWR7E
Amenorrhea
The document discusses amenorrhea, its classification, causes, diagnosis and management. It defines primary amenorrhea as the absence of menstruation by age 16 and secondary amenorrhea as absence of periods for 3 months in a previously menstruating woman. The main causes outlined include hypogonadotropic hypogonadism, polycystic ovary syndrome, premature ovarian failure, hyperprolactinemia, and weight-related issues. The diagnostic approach involves assessing the history, physical exam, ultrasound and hormonal levels. Management focuses on restoring ovulation if possible, or replacing hormones as needed to prevent health issues.
Amenorrhea
Amenorrhea is the absence of menstrual periods and is divided into primary and secondary types. Primary amenorrhea refers to the absence of periods by age 14 with no sexual development, or by age 16 with normal development. Secondary amenorrhea is defined as missing periods for 3 cycles or 6 months in women who previously menstruated regularly. Potential causes include pregnancy, breastfeeding, medical conditions, eating disorders, excessive exercise, and medications. Diagnosis involves medical history, physical exam, and lab tests. Treatment focuses on addressing the underlying cause through lifestyle changes, medication, surgery, or hormone therapy. Nurses educate and counsel patients, and emphasize healthy lifestyle behaviors.
Premature ovarian failure
This document summarizes information about premature ovarian failure (POF). It defines POF as amenorrhea, hypoestrogenism, and elevated gonadotropins in women under age 40. POF prevalence is 1-4% under age 40, increasing to 1% by age 30 and 4% by age 40. Causes include genetic factors, autoimmunity, environmental exposures, infections, and iatrogenic factors. Symptoms include menopausal symptoms and long term risks of osteoporosis and cardiovascular disease. Diagnosis involves lab tests of hormones and imaging. Treatment is hormone replacement therapy. Annual follow up is needed to monitor treatment and screen for other related conditions.
Dysfunctional uterine bleeding
Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding without an underlying cause. It affects 50-60% of women and common symptoms include heavy or prolonged menstrual periods. The cause is often unknown but may involve imbalances in hormones that regulate the uterine lining. Diagnosis involves assessing symptoms, signs of anemia, and testing is usually not needed for young women. Treatment options range from intrauterine devices to relieve heavy bleeding, to oral medications, hormone therapy, endometrial ablation, and hysterectomy as a last resort. The goal is to control symptoms through minimally invasive options before considering more intensive surgeries.
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The term metrorrhagia is often used for irregular menstruation that occurs between the expected menstrual periods. Oligomenorrhea is the medical term for infrequent, often light menstrual periods (intervals exceeding 35 days). Amenorrhea is the absence of a menstrual period in a woman of reproductive age.
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Dr. Tarig Mahmoud discusses various causes and types of early pregnancy bleeding and miscarriage. There are several potential causes of miscarriage, including fetal chromosomal abnormalities, maternal medical conditions, infections, and uterine/cervical issues. The main types of miscarriage are threatened, inevitable, incomplete, complete, and missed. Recurrent miscarriage is defined as three or more consecutive losses. Septic miscarriage can occur if an incomplete miscarriage leads to an ascending infection. Counseling is important to reassure patients and provide psychological support after a miscarriage.
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This clinical document provides guidelines for evaluating and managing amenorrhea. It defines primary and secondary amenorrhea and outlines the pathophysiology. The evaluation involves assessing the patient's history, physical exam, ultrasound and hormonal levels. Common causes include polycystic ovary syndrome, premature ovarian failure, hypothalamic issues, weight-related causes, and structural issues. Management aims to restore ovulation if possible or provide hormone replacement therapy to prevent health issues from estrogen deficiency.
Primary amenorrhea
Primary amenorrhea is defined as no menstrual periods by age 16. Investigations into primary amenorrhea depend on whether secondary sex characteristics are present or absent. Causes can be physiological, pathological, anatomical, endocrinological, or chromosomal. Common causes include hypothalamic or pituitary disorders, chromosomal abnormalities like Turner's syndrome, congenital adrenal hyperplasia, androgen insensitivity syndrome, or müllerian agenesis. Treatment depends on the underlying cause but may include hormone replacement therapy, vaginal dilation, vaginoplasty, or gonadectomy.
Menstrual disorders
This document discusses the diagnosis and management of menstrual disorders. It begins by reviewing normal menstrual physiology and providing terminology used to describe different types of menstrual disorders. It then discusses the general approach to taking a history and performing an examination for patients presenting with menstrual complaints. Specific sections cover the evaluation and treatment of dysmenorrhea, menorrhagia, amenorrhea, and anovulatory bleeding. Causes and management approaches are provided for different menstrual disorders.
Pelvic organ prolapse
This document provides an overview of pelvic organ prolapse. It defines prolapse as the descent of pelvic organs, like the bladder, bowel or uterus, into the vagina due to weakness in their supporting structures. It discusses the epidemiology, relevant anatomy, risk factors, classification, clinical features and management. Conservative options include lifestyle changes, pelvic floor exercises and pessaries. Surgical management ranges from repairs to more radical procedures like hysterectomy, depending on the severity of prolapse and patient factors. The goal of treatment is to relieve symptoms and support the pelvic organs in their proper anatomical position.
Types of Menstrual disorders and there causes and symptoms
In this slide, you can understand the types of menstrual disorders, Mahvari or haiz.
You can learn about the types of Menstruation.
Types of Menstrual disorders.
cause of menstruation
symptoms of menstruation
diagnosis of menstruation
Treatment of menstruation bleeding
Heavy bleeding or menstrual cramps
Menstrual cycle
Amenorrhea
Dysmenorrhea
Oligo menorrhea
PMS (Premenstrual syndrome) or PMDD (Premenstrual dystrophic disease)
Menorrhagia
You can download Powerpoint of menstrual disorders here:
https://docs.google.com/presentation/d/1SCDUYcPYP7vpE4kzWoBwzYnyg4vzNAcXWrFp_iIZAnA/edit#slide=id.p1
You can download video from:
https://youtu.be/APWG2liWR7E
Amenorrhea
The document discusses amenorrhea, its classification, causes, diagnosis and management. It defines primary amenorrhea as the absence of menstruation by age 16 and secondary amenorrhea as absence of periods for 3 months in a previously menstruating woman. The main causes outlined include hypogonadotropic hypogonadism, polycystic ovary syndrome, premature ovarian failure, hyperprolactinemia, and weight-related issues. The diagnostic approach involves assessing the history, physical exam, ultrasound and hormonal levels. Management focuses on restoring ovulation if possible, or replacing hormones as needed to prevent health issues.
Amenorrhea
Amenorrhea is the absence of menstrual periods and is divided into primary and secondary types. Primary amenorrhea refers to the absence of periods by age 14 with no sexual development, or by age 16 with normal development. Secondary amenorrhea is defined as missing periods for 3 cycles or 6 months in women who previously menstruated regularly. Potential causes include pregnancy, breastfeeding, medical conditions, eating disorders, excessive exercise, and medications. Diagnosis involves medical history, physical exam, and lab tests. Treatment focuses on addressing the underlying cause through lifestyle changes, medication, surgery, or hormone therapy. Nurses educate and counsel patients, and emphasize healthy lifestyle behaviors.
Premature ovarian failure
This document summarizes information about premature ovarian failure (POF). It defines POF as amenorrhea, hypoestrogenism, and elevated gonadotropins in women under age 40. POF prevalence is 1-4% under age 40, increasing to 1% by age 30 and 4% by age 40. Causes include genetic factors, autoimmunity, environmental exposures, infections, and iatrogenic factors. Symptoms include menopausal symptoms and long term risks of osteoporosis and cardiovascular disease. Diagnosis involves lab tests of hormones and imaging. Treatment is hormone replacement therapy. Annual follow up is needed to monitor treatment and screen for other related conditions.
Dysfunctional uterine bleeding
Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding without an underlying cause. It affects 50-60% of women and common symptoms include heavy or prolonged menstrual periods. The cause is often unknown but may involve imbalances in hormones that regulate the uterine lining. Diagnosis involves assessing symptoms, signs of anemia, and testing is usually not needed for young women. Treatment options range from intrauterine devices to relieve heavy bleeding, to oral medications, hormone therapy, endometrial ablation, and hysterectomy as a last resort. The goal is to control symptoms through minimally invasive options before considering more intensive surgeries.
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The term metrorrhagia is often used for irregular menstruation that occurs between the expected menstrual periods. Oligomenorrhea is the medical term for infrequent, often light menstrual periods (intervals exceeding 35 days). Amenorrhea is the absence of a menstrual period in a woman of reproductive age.
Puberty menorrhagia dr. kawita bapat
This document discusses abnormal uterine bleeding (AUB) or menorrhagia in puberty. It lists various potential causes of AUB including anovulation, polyps, adenomyosis, leiomyoma, and bleeding disorders. Anovulation due to an immature hypothalamic-pituitary-ovarian axis is the most common cause. The document provides guidelines on evaluating AUB, including taking a detailed history, physical exam, lab tests, and ultrasound. Differential diagnoses are discussed. Bleeding disorders are more commonly platelet dysfunction disorders in Southeast Asia, unlike the West where Von Willebrand disease is more common.
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- 1. Menstrual Disorders P. Akshay Khumar A Physiological and clinical approach…..
- 2. Normal aspects of Menstrual cycle • Cycle length 20-40 days ( Dec. with age advan) • Duration of flow of menses 2-7 days • Avg blood loss 40cc Excess if >80cc • Menses: 50-75% blood • Do not usually clot due to the presence of fibrinolytics
- 3. Symptoms….. • Usually unpleasant • Often associated with cramps • Mainly due to hormonal withdrawl
- 4. Disorders: Pre-Menstrual syndrome (PMS) Abnormal Menstruation Dysfunctional uterine bleeding (DUB)
- 5. Pre-Menstrual syndrome (PMS) • Occurs for 4 to 5 days prior to menstruation • It’s due to water and electrolyte imbalance produced by oestrogen
- 6. Abnormal menstruation • Menorrhagia (hypermenorrhea): uterine bleeding excessive in both amount and duration of flow, but occurring at regular intervals. • Metrorrhagia: uterine bleeding occurring at irregular intervals. • Menometrorrhagia: uterine bleeding usually excessive and prolonged occurring at frequent and irregular intervals • Oligomenorrhea: menstrual periods at intervals of more than 35 days. (Decreased frequency) • Polymenorrhea: frequent but regular episodes of uterine bleeding occurring at intervals of 21 days or less.(Increased Frequency) • Hypomenorrhea: uterine bleeding that is regular but decreased in amount. • Intermenstrual bleeding: uterine bleeding, usually not excessive, occurring at any time during the menstrual cycle other than during normal menstruation.
- 7. Dysfunctional uterine bleeding (Anovulatory cycle…) • Blood flow is usually excessive in duration, amount and frequency. • More common during the perimenarcheal and perimenopausal years. • Usually episodes are transient and self limiting.
- 8. Causes: • Causes for disturbed function can be central, intermediate, end organ, and physiologic. • Central causes: immaturity of the hypothalamic- pituitary axis; traumatic, polycystic ovarian disease. • Psychological factors: anxiety, stress, emotional trauma • Intermediate causes: chronic illness, metabolic or endocrine diseases, nutritional disturbances. • Peripheral causes: functional ovarian cyst, functional tumors, premature ovarian failure • Physiologic: perimenarcheal and perimenopausal
- 9. Management: • Control excessive bleeding and recurrence • Iron supplements • Maintain Plasma Volume • Proper nutrition • Symptomatic treatment….
- 10. Conclusion • Menstrual disorder is a common complaint. • Specific pathologies are associated with its occurrence in different age groups (pubertal years, reproductive age and perimenopausalperiod). • Requires proper evaluation and specific treatment
- 11. Thank You…..