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31 Cards in this Set
- Front
- Back
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what is dysmenorrhea?
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painful menstruation
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what ages does primary dysmenorrhea usually occur in?
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17-22
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what is primary dysmenorrhea?
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painful menstruation in the absence of pelvic pathology
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what is secondary dysmenorrhea?
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painful menstruation resulting from an identifiable pelvic pathology
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what do sloughing endothelial cells release? (2)
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PGF2
PGE2 |
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what do releasing prostaglandins during menses cause? (2)
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myometrial contraction
vasoconstriction |
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when does primary dysmenorrhea usually set in?
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within 2 years of menarche
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when does lower abdominal and pelvic pain begin and end with primary dysmenorrhea?
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onset of menses
ends 48-72 hours later |
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what are 7 pathological causes of secondary dysmenorrhea?
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endometriosis
adenomyosis IUD use pelvic congestion fibroids pelvic inflammatory disease ovarian cysts |
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what are 4 clinical features of secondary dysmenorrhea?
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infertility
heavy or irregular menstrual flow dyspareunia vaginal discharge |
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how do anti-prostaglandins help with primary dysmenorrhea?
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decrease COX enzyme to inhibit prostaglandin synthesis and metabolism
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when should NSAIDs be given for primary dysmenorrhea?
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at the earliest onset of symptoms, sometimes 1-2 days before
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what are tocolytic agents?
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analgesics
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what are 2 tocolytic agents?
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salbutomol
nifedipine (ca2+ channel blocker) |
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how should you treat resistant primary dysmenorrhea cases?
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proestogens
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what are 2 proestogens?
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medroxyprogesterone
dygogesterone |
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how do proestogens work?
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decrease endometrial lining
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what has been shown to be as effective ibuprofen in treating primary dysmenorrhea?
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low-level topoical heat
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what types of diets are helpful in primary dysmenorrhea and why?
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diets low in fat and meat products because they decrease the serum sex binding globulin which then decreases the duration and intensity of dysmenorrhea
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what is endometriosis?
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growth of endometrial tissue in sites outside the endometrial cavity
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where can endometrial tissue be found in endometriosis? (4)
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pelvic cavity
ovaries uterosacral ligaments pouch of douglas |
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what are 6 symptoms of endometriosis?
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dyspareurnia
dysmenorrhea chronic LBP pelvic pain adnexal masses subfertility |
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what percentage of dysmenorrhea patients have endometriosis?
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40-60%
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what percentage of patients with subfertility have endometriosis?
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20-30%
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what is the most common age for diagnosis of endometriosis?
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40
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what are 2 risk factors for endometriosis?
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environmental toxins
hereditary |
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what is coelomic metaplasia?
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the theory that certain cells, when stimulated, can transform themselves into a different kind of cells
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what is the only diagnostic test that can reliably rule our endometriosis?
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laparoscopy
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what are 4 medical options for endometriosis treatment?
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oral contraceptives
progestins androgenic agents GnRH analogues |
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how should you base treatment for endometriosis?
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side effect profiles
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what are 3 surgical options for endometriosis?
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laparoscopy
surgical laser or thermal ablation surgical excision |
