Chapter 6

Question 1

AMENORRHEA
-What is amenorrhea?

Answer 1

The absence of menstrual flow

Question 2

AMENORRHEA
-What three conditions should be evaluated?

Answer 2

1. Absence of menarche & secondary sexual characteristics by 13
2. Absence of menses by 15
3. Absence of menstruation within 5 years of breast development

Question 3

AMENORRHEA
-What is secondary amenorrhea?

Answer 3

Cessation of menses for 6 months OR MORE after a period of menstruation

Question 4

AMENORRHEA
-What may early onset menstruation occur with?

Answer 4

Obesity

Question 5

AMENORRHEA
-What are 6 things from which amenorrhea may result from?

Answer 5

1. Pregnancy
2. Anatomic abnormalities (outflow tract obstruction)
3. Endocrine dysfunction (Ant. pituitary disorders, PCOS, hypothyroidism)
4. Chronic diseases (T1D)
5. Drug & alcohol use
6. Use of oral contraceptive

Question 6

PREMENSTRUAL PAIN & DISCOMFORT
-What does this include?

Answer 6

1. Dysmenorrhea
2. PMS
3. Premenstrual dysphoric disorder (PMDD)
4. Symptom clusters that occur before & after menstrual flow starts

Question 7

DYSMENORRHEA: Primary
-What is this

Answer 7

Pain that occurs during or shortly before menstruation

Question 8

DYSMENORRHEA: Primary
-What does this arise from?

Answer 8

The release of prostaglandins with menses

Question 9

DYSMENORRHEA: Primary
-What does excessive release of PGF2a do?
-What does this result in?

Answer 9

1. increases amplitude & frequency of uterine contractions
2. causes vasospasm of the uterine arterioles
   -Ischemia & cyclic lower abdominal cramps

Question 10

DYSMENORRHEA: Primary
-What are the typical systemic responses to PGF2a?

Answer 10

1. Backache
2. Weakness
3. Diaphoresis
4. GI symptoms (anorexia, N/V, diarrhea)
5. CNS symptoms (dizziness, syncope, headache, poor concentration)

Question 11

DYSMENORRHEA: Secondary
-What is this?

Answer 11

Menstrual pain that develops later in life than primary dysmenorrhea

Question 12

DYSMENORRHEA: Secondary
-It is associated with a pelvic pathology such as what? (5)

Answer 12

1. Adenomyosis
2. Endometriosis
3. Pelvic inflammatory disease
4. Endometrial polyps
5. Submucous or interstitial myomas (fibroids)

Question 13

PREMENSTRUAL SYNDROME (PMS)
-What is this?

Answer 13

Cluster of symptoms that occur before menstruation & resolve at the start of menses

Question 14

PREMENSTRUAL SYNDROME (PMS)
-What are the cluster of symptoms? (4)

Answer 14

Mood changes, bloating, headaches, & irritability

Question 15

ENDOMETRIOSIS
-What is this?

Answer 15

When tissue similar to the uterine lining grows outside the uterus

Question 16

ENDOMETRIOSIS
-What are the symptoms? (4)

Answer 16

1. Pelvic pain
2. Painful intercourse (dyspareunia)
3. Infertility issues
4. Heavy or irregular bleeding

Question 17

PERIMENOPAUSE
-What is this?

Answer 17

Transition phase BEFORE complete menopause

Question 18

PERIMENOPAUSE
-What 4 things can women experience?

Answer 18

1. Irregular bleeding
2. Hot flashes (vasomotor instability)
3. Mood changes
4. Sleep disturbances

Question 19

MENOPAUSE
-What is this?

Answer 19

Permanent cessation of menstruation

Question 20

LONG-TERM HEALTH RISKS AFTER MENOPAUSE
-What two things can happen?

Answer 20

1. Osteoporosis
2. Increased CV risk

Question 21

LONG-TERM HEALTH RISKS AFTER MENOPAUSE
-What is osteoporosis?
-Why does it happen?

Answer 21

-Loss of bone mass
-because of low estrogen

Question 22

LONG-TERM HEALTH RISKS AFTER MENOPAUSE
-Why is there increased CV risk?

Answer 22

Due to changes in lipid metabolism