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73 Cards in this Set
- Front
- Back
menstrual cycle length |
determined from the first day of one menses to the first day of of the next menses. once established cycle length is 21-35 days. |
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amount of flow |
on average 25-60 mL blood loss over 80 mL is considered abnormal |
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length of menses |
2-8 days |
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hypomenorrhea |
short duration of menstrual flow or, in other words, uterine bleeding at normal intervals but in decreased amounts. |
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hypermenorrhea |
an abnormally long or heavy menstrual flow at normal intervals (sometimes used interchangeably with menorrhagia). |
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oligomenorrhea |
bleeding, often irregular, occurring in intervals greater than 40 days. |
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polymenorrhea |
bleeding, either regular or irregular, occuring at intervals of less than 22 days. |
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menorrhagia |
bleeding that is excessive in amount and duration, which occurs at regular intervals |
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metrorrhagia |
bleeding, usually of a normal amount, occurring at irregular intervals. |
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menometrorrhagia |
bleeding that is excessive in amount and duration, which occurs at either regular or irregular intervals.
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intermenstrual bleeding |
bleeding occurring between regular menstrual cycles. |
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amenorrhea |
the absence of menses. primary or secondary. |
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primary amenorrhea |
menstruation has not been established by age 16 |
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secondary amenorrhea |
an established menses (of longer than 3 months) ceases. |
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Causes of amenorrhea |
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dysmenorrhea |
painful menses. occurs at or a day before, the onset of menstruation and disappears by the end of menses. primary or secondary. |
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primary dysmenorrhea |
defined as cramps without underlying disease. prostaglandins F2 and F2a which are produced by the uterus in higher concentrations during menses, are the primary cause. they increase uterine contractility and decrease uterine artery blood flow causing ischemia. the end result is the painful sensation of cramps. |
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secondary dysmenorrhea |
associated with pathology of the reproductive tract and usually appears after menstruation has been established. |
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causes of secondary dysmenorrhea |
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premenstrual syndrome (PMS) |
a symptom complex associated with the luteal phase of the menstrual cycle. 70-90% of women report physical or emotional changes premenstrually. diagnosis is made when symptoms appear for three consecutive cycles. |
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premenstrual dysphoric disorder (PMDD) |
affects 3-8% women must experience five or more symptoms in the given time frame, which are relieved with menstruation and have occurred during most cycles during the previous year. markedly interferes with work, school, and relationships and must not merely be worsened symptoms of another disorder such as major depressive disorder, panic disorder, or personality disorder. |
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psychologic symptoms of PMS |
irritability, lethargy, depression, low morale, anxiety, sleep disorders, crying spells, hostility, decreased concentration |
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neurologic symptoms of PMS |
classic migraine, vertigo, syncope |
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respiratory symptoms of PMS |
rhinitis, hoarseness |
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gastrointestinal symptoms of PMS |
nausea, vomiting, constipation, abdominal bloating, increased appetite or food cravings |
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urinary symptoms of PMS |
retention and oliguria |
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dermatologic symptoms of PMS |
acne |
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mammary symptoms of PMS |
swelling and tenderness |
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musculoskeletal symptoms of PMS |
joint or muscle pain |
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menopause |
defined as the absence of menstruation for 1 full year, is a time of transition for a woman, marking the end of her reproductive abilities. occurs between 45-52 years, average age is 51.3. |
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climacteric |
change of life refers to the host of psychologic and physical alterations that occur around the time of menopause. |
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perimenopause |
refers to the period of time before menopause during which the woman moves from normal ovulatory cycles to cessation of menses. |
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What kind of risks are there for a pregnancy when a woman is over 40? |
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non-contraceptive benefits of oral contraceptives during perimenopause: |
Healthy non-smokers benefit by
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what types of cancer will oral contraceptives decrease the risk of during perimenopause? |
endometrial and ovarian |
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what are other factors that may contribute to the psychological aspects of menopause? |
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what factors influence how a woman copes with climacteric changes? |
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on average, how much of a woman's life will be lived after menopause? |
1/3 |
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beginning 2-8 years before menopause, women experience: |
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physical changes in the reproductive system include: |
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vasomotor changes |
80-90% of women who are perimenopausal or menopausal experience hot flashes, typically described as a feeling of heat rising from the chest and spreading to the neck. can happen up to 20-30 times a day. some women also experience dizzy spells, palpitations, and weakness. |
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osteoporosis |
a decrease in bone strength related to diminished bone density and bone quality, is a major health concern for women |
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lowered estrogen causes: |
osteoporosis |
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risk factors for osteoporosis |
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number one killer of women |
cardiovascular disease (CVD) 300,000 women die each year from coronary heart disease. six times higher than those deaths caused by breast cancer. |
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metabolic syndrome |
is a major predisposing factor for coronary heart disease and is defined through a collection of risk factors. clinical characteristics are weight measurement greater than 35 inches, triglycerides grater than 150 mg/dL, HDL less than 50, blood pressures over 130/85, and fasting glucose levels greater than 110 mg/dL. |
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risk factors for CHD in women |
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Alzheimer's disease |
most commonly occurring form of dementia, estimated to affect 4.5 million Americans. new cases are projected to double between 2010 and 2050 |
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spontaneous premature menopause premature ovarian insufficiency |
is a devastating event and is not well understood, although family history is a major influencing factor. it occurs in 1% of women under age 40 and is demonstrated by the development of amenorrhea, a sharp decline in estrogen levels, and a rise in follicle-stimulating hormone (FSH). 5-10% of cases will spontaneously reverse. |
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treatment of premature menopause |
estrogen and progesterone therapy until the usual age of menopause. |
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premature menopause can also be caused by: |
anorexia, chemotherapy or radiation treatments, and oophorectomy (surgical removal of the ovaries. |
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hormone replacement therapy (HRT) |
refers to the administration of specific hormones to alleviate symptoms associated with the changes of menopause. |
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estrogen therapy |
given to women who have undergone a hysterectomy. |
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combined estrogen-progesterone therapy |
used for women with an intact uterus for the relief of vasomotor symptoms and urogenital and vaginal symptoms, as well as osteoporosis prevention. |
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why is progesterone added to HRT for women with an intact uterus? |
unopposed estrogen increases the risk of endometrial cancer by eightfold and therefore is never given without progesterone in these women. |
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modes of HRT delivery: |
orally, transdermally (patch, gel, lotion), vaginal creams, or vaginal ring. |
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the primary indication for HRT |
treatment of menopausal symptoms such as hot flashes and urogenital symptoms is the primary indication for HRT and estrogen therapy (ET) |
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HRT cannot prevent: |
coronary heart disease (CHD) |
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methods of CHD prevention: |
weight control, regular exercise, no smoking, healthy diet, etc. |
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testosterone may be added to HRT to: |
improve sexual desire, responsiveness, and frequency. |
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bioidentical hormones |
structurally identical to the hormones produced by the ovaries. may be safer and more effective. |
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what should be done prior to beginning HRT? |
a through history, physical examination, pap smear, measurement of cholesterol, lipids, and liver enzyme levels; baseline mammogram. endometrial biopsy for those at heightened risk of endometrial cancer and if excessive, prolonged, or unexpected bleeding occurs. |
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women who are on HRT should report these symptoms immediately |
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ACOG recommends bone mineral density (BMD) testing for: |
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BMD testing may also be indicated for: |
pre or postmenopausal women with certain medical conditions:
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biophosphonates |
reduce bone resorption and bone loss by inhibiting osteoclast activity. the two most common, alendronate (Fosamax) and risedronate (Actonel) are both taken upon arising in the morning on an empty stomach with a full glass of water. |
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selective estrogen receptor modulators (SERMs) |
have estrogen-like properties. the SERM approved for osteoporosis treatment, reloxifene (Evista), acts like estrogen by protecting against osteoporosis but does not stimulate uterine or breast tissue. does not relieve other menopausal symptoms and may increase hot flashes, so it is indicated in asymptomatic women who want preventative therapy for osteoporosis. |
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salmon calcitonin |
a calcium regulator that may inhibit bone loss and is approved for use to treat osteoporosis in women who are 5 years postmenopause. administered as a nasal spray, its value is less clear than that of other medications listed. |
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parathyroid hormone |
a daily subcutaneous injection, activates bone formation, which results in substantial increases in bone density |
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ultra-low-dose estrogen patches |
Menostar have proven to treat osteoporosis and can be used with out a progestogen. these small doses are found to demonstrate effective prevention of fracture without the increased side effects or risks of endometrial stimulation found in larger dose estrogen patches |
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signs of myocardial infarction in women |
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phytoestrogens |
plant products that have estrogen-like properties and may help relieve some menopausal symptoms, although it is not clear whether relief comes from estrogens or other substances in plants. foods include carrots, yams, and soy. |
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herbal supplement phytoestrogens |
black cohosh, dong quai, red clover, soy isoflavones, ginseng, and kava |