Folicular phase- physio
- Estrogen!
- FSH>LH
- 0-14
- Mentruation = 1st day of follicular/ proliferative phase
Ovulation phase- physio
- Surge of LH
Luteal phase- physio
- Progesterone
- Corpeus leuteum
- FSH>LH
Cervical CA screening
- Age 21-65 Q 3 y
- PAP + HPV = 5 years
- 65+ 3 consecutive negatives
Paps- ASC-US: 21-24
- MC
Age 21-24: - Repeat 1 Y
- 2x normal -> Q 3 y
Paps- ASC-US: 25+
- HPV test, + = colposcopy and bx
HPV Negative = Q 3 y
ASC-H
Colposcopy
LSIL: 25-29
Colposcopy
LSIL: 30+
HPV test
If -, repeat 1 y
If +, colposcopy
LSIL- CIN 1
- Observation
- Excision- leep, cold knife
- ablation
HSIL-
Colposcopy c bx
- CIN 2 (2/3 thickness) or 3
- Excision and ablation
- Leep, cold knife
Glandular cells
Colposcopy, endometrial neoplasia
HPV vaccine
- 3 doses, starting at age 11
Transabd US
- Pregnancy, difficult vag exams
Colposcopy
Visualization of cervix/ vag
- c acetic acid
- Abn paps
Hysteroscopy
Viz uterine cavity, endocervical canal
- Endometrial hyperplasia or carcinoma
Hystersalpingogram
- Radiopaque dye into cervix
- Patently of ovarian ducts, infertility or procedures
Transvag US
- Preg, IUD placement, bleeding, ovarian pain
Pelvic CT/ MRI
- CA, mets,
- MRI better for inflammation, CA, abn tissues
Menorrhagia
Heavy, prolonged bleeding
- > 80 mls
- Normal intervals
Metorrhagia
Bleeding between cycles
Menometrorrhagia
irregular intervals, irregular bleeding
Oligomenorrhea
Prolonged length between cycles, > 35 d,
Combination oral contraceptives
- Estrogen + progesterone
- Prevents mid cycle surge of LH
- Thins endometrium
- Acne, dysmenorrhea
