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30 Cards in this Set

  • Front
  • Back
Primary Dysmenorrhea
•!Begins with menarche
•!No abnormal pathological cause
•!Treatment
–!Heat – relaxes muscles & decreases uterine ischemia
–!Massage – relaxes muscles & increases pelvic blood supply
–!Biofeedback, medication, low fat diet
–!NSAIDS – anti-inflammatory
–!BC Pill – inhibits ovulation & decreases Menses
Amenorrhea
•!Absence of flow
•!Causes:
–!Anxiety
–!Fatigue
–!Chronic Illness
–!Extreme dieting (often seen in Anorexia Nervosa)
–!Extreme training (low weight or low body fat, often seen in
Olympic athletes or marathon runners
–!PCOS
Secondary Dysmenorrhea
•!Starts later (25 years old or more) after years of painless
menstruation
•!Pain usually starts several days before menses
•!Causes:
–!Endometriosis
–!PID
–!Polyps
–!Fibroids
Metrorrhagia
Bleeding between periods
•!In adolescence (middle straining)
•!When on BC pills (breakthrough bleeding)
•!Vaginal infections
•!Uterine carcinoma or cysts
Menorrhagia
•!Unusually heavy flows (over 80cc) or saturating pad or
tampon in about 1 hr
•!Puberty or near menopause more common
•!Causes:
–!Endometriosis
–!Blood dyscrasia
–!Cycle not yet developed
•!Anemia can result
•!Treatment
–!BC pills, Progesterone, Iron supplement
Endometriosis
•!Tissue outside of uterus
•!Responds to hormones during cycle & causes pain
•!“Menses” of these tissues collect in cyst-like sacs – rupture
causes PAIN
Endometriosis Symptoms
–!Dysmenorrhea (painful menses)
–!Infertility
–!Pelvic pain
–!Dyspareunia (pain with intercourse)
–!Irregular bleeding
Endometriosis Treatment
•!Medication
–!Estrogen & Progestin (stop menses)
–!Danazol (synthetic androgen) causes pseudo-menopause
•!Side effects- causes Amenorrhea, Sometimes weight gain
–!Leuprolide (gonatropin-releasing analog)causes hypoestrogenic state (similar to menopause)
•!Side effects-Headache,Hot flashes, Edema
Endometriosis Treatment (cont)
•!Surgery
–!Removal of endometrial cysts
–!Vary in severity
–!Drug therapy is often used first to shrink areas
Toxic Shock Syndrome
•!Caused by staphylococcus that penetrates vaginal wall
–!Tampons left too long (use pads at night)
–!“super” Tampons
•!Symptoms: (can be life threatening)
–!N & V
–!Temp > 102 F
–!Decreased renal & liver function
–!Shock
PMS
Symptoms occur between ovulation & menses
•!Irritability
•!Lethargy
•!Depression
•!Migraines
!Asthma, nasal congestion
•!N & V, cravings, hypoglycemia
•!Oliguria, fluid retention
•!Acne
•!Mammary swelling & tenderness
•!Hormone imbalance
•!Serotonin imbalance
PMS - Tx
–!Restrict ETOH, chocolate, caffeine, red meat, salt, sugar
–!Vitamin B-6 (decrease anxiety)
–!Vitamin E (decrease breast tenderness)
–!Psychotropic drugs
–!Progesterone
–!Diuretics
Menopause
Can Lead To
Hot flashes
Night sweats
Vaginal atrophy
Discomfort
Interrupted sleep
Fatigue, mood changes
Vaginal irritation, painful sex
Bone loss
Osteoporosis
Fractures
Decrease HDL
Increase LDL
Increase cholesterol
Increased risk for clogged arteries
Increased risk for CAD
Hormone Replacement-
Estrogen and Progesterone
•!Post hysterectomy – only use estrogen
•!Breast self-exam
•!Mammogram
•!Annual pap
•!Need for Calcium
Hormone Replacement •!Combination therapy
•!Prempro (estrogen & progestin)
–!Increases the risk of:
•!Breast cancer
•!Clots and gallbladder disease
•!Heart disease
•!Irregular vaginal bleeding
Hormone Replacement
•!Estrogen
–!The longer one is exposed to estrogen the greater the risk of
breast cancer & endometrial cancer
•!HRT
•!Early menarche (before 12)
•!Late menopause (after 55)
Hormone Replacement
•!Alternative therapy
–!Increase fiber, decrease fat diet, Vitamin D & E,
Phytoestrogens (soy)
•!Exercise – weight bearing & resistance
•!Relaxation
•!Calcium Supplement
Chlamydia
Reportable disease
•!Gram Negative bacteria
•!If a person has Gonorrhea the MD will usually treat for Chlamydia also because it is so prevalent
Gonorrhea
•!Reportable disease
•!Gram negative Diplococus
•!Resistant strains
•!Many have both Chlamydia & Gonorrhea
•!Treatment
–!Co-treat for both infections
•!Rocephin
•!Doxycycline
PID
•!Untreated STD can cause permanent damage to female
reproductive organs
•!Need prompt and appropriate treatment
•!Sometimes silent invasion and scarring
•!Total blockage/damaged tube – ectopic pregnancy
•!Chronic pelvic pain
Syphilis
•!Stages
–!Primary – chancre (lips, genital areas)
–!Secondary – hair loss, rash (palms, soles & mucus
membranes), moist papules (anal & genital)
–!Latent – no S & S
–!Late – (Tertiary) – destructive bone & skin lesions, heart
failure & valve involvement, CNS involvement
Herpes
Virus along the course of a nerve
•!“Herpes is Forever”
•!Can cause neurological damage
•!In Pregnancy
•!Zovirax
Chondylomata Acuminata
(Genital Warts)(HPV)
•!Linked to cervical cancer
•!May form large clumps
•!Can be spread to newborn
•!Treatment
–!Condylox/
–!Cryotherapy
–!Laser
–!Surgical excision
Gardiasil
•!9-26 year olds
•!Protection from some strains of HPV
Domestic Abuse
•!Affects 2-4 million women each year
•!Physical (battery)
•!Sexual
•!Verbal
•!Psychological
•!Economic coercion
•!Affects all segments of society
•!May begin with threats and escalate
Characteristics of Abusive Relationships
•!Low self esteem
•!Poor uneducated women
•!Believe they are to blame
•!May have history of violence growing up
•!Fear societal rejection
Mastagia
•!Pain in breast (70% of women)
•!Usually due to hormone influence & related to menses
•!Breast fullness or heaviness
•!If new condition may need mammogram
Uterine Relaxation Problems
•!Cystocele
•!Rectocele
•!Prolapsed uterus
•!Fistulas
Cystocele
Protrusion of bladder through the anterior vaginal wall
•!Vaginal wall is weak
•!Urethra is displaced
•!Can cause stress incontinence
Fistulas
Tear or ulcer in an organ
•!Can be caused by:
–!Cancer
–!Surgery
–!Difficult delivery
–!Radium implants