DISORDER - D ISORDER DEF I N I T I ON PATHOGENESIS CL I N...

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Unformatted text preview: D ISORDER DEF I N I T I ON PATHOGENESIS CL I N ICAL MAN I FESTATIONS D IAGNOSIS TREATMENT Dysmenorhea Painful periods-incidence steadly rises, peaks in women in their 20s, then steadily declines PRIMARY ..results from excessive protoglandin F found in secretory endometrium ..these hormones restrict myometrial contraction, constrict blood vessels causing ischemia and shedding SECONDARY Results from disorders such as endometrios, pelvic adhesions, inflammatory disease, uterine fibroids-pelvic pain associated with the onset of menses-severity related to length and amount of flow-discomfort usually begins before menstruation and rarely persists beyond the second day-pain often radiated in groin-backache, anorexia, vomiting, headache, syncope (temporary loss of consciousness, posture)-differentiate between primary and secondary with pelvis exam-prostaglandin inhibitors-hormonal contraception to decrease prostaglandin synthesis and myometrial contractibility-regular exercise-heat, relaxation, message Primary Amenorrhea Lack of menstruation Failure of menarche and absence of menstruation by age 14 with no development of secondary sex characteristics or absence of menstruation by age 16 with secondary sex characteristics-can be hypothalamic-primary- ovarian axis dysfunctional and ovaries never receive hormonal signals-can be from absence or hypoplasia of uterus and some genetic disorders like turners (lack of gametes) and AIS (genially a male) Secondary sex characteristics and height affected History, physical exam, lab work-correction of any disorder-hormone supplements-surgery Secondary Amenorrhea Lack of menstruation Absence of menstruation for three cycles or 6 months in woman who have previously menstruated *normal in adolescence, pregnancy and premenapause Caused by hyperprolactinemia, intrinsic (tumor, head trauma) or extrinsic (starvation, psychogenic disturbance, endocrine disease, hypothalamic pituitary disorders Infertility, vascomotor flushes, vaginal atrophy, acne, hairness Pregnancy most common cause; others can be evaluated by hormonal and anatomical diagnostics or evaluation of thyroid secreting hormone Hormones or corrective procedure Abnormal Uterine Bleeding (Dysfunctional Uterine Bleeding- DUB) Menstrual irregularity or abnormal bleeding patterns DUB: abnormal uterine bleeding resulting from a disturbance of menstrual cycle, usually anovulation-most common cause is failure to ovulate related to age or endocrinopathy-progesterone deficiency or estrogen excess (imbalance) *abnormal bleeding in ovarian cycles is less common and may be from fibronlytic activity; changes in prostaglandin production; or structural abnormality-unpredictable and variable bleeding in terms of amount and duration-flooding and large clots (esp in premenopause)-healthy woman usually do not become anemic-most likely to effect woman at extremes of reproductive years-heavy bleeding may be preceded by episodes of amenorrhea or miscarriage...
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This note was uploaded on 07/12/2011 for the course NURSING 000 taught by Professor Clark during the Spring '11 term at Alabama.

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DISORDER - D ISORDER DEF I N I T I ON PATHOGENESIS CL I N...

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