Abnormal Uterine Bleeding Patterns

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Questions and Answers

What is polymenorrhea and how does it differ from normal menstrual cycles?

Polymenorrhea is characterized by abnormally frequent menses occurring at intervals less than 21 days. In contrast, normal menstrual cycles typically range from 21 to 35 days.

Define menorrhagia and state its volume criteria.

Menorrhagia is defined as excessive menstrual bleeding, typically over 80 ml, and/or prolonged menses lasting more than 7 days at normal intervals. This condition is cyclic in nature.

What distinguishes metrorrhagia from other types of abnormal uterine bleeding?

Metrorrhagia involves irregular episodes of uterine bleeding that are acyclic, meaning they do not follow the regular menstrual cycle. This differentiates it from cyclical uterine bleeding patterns.

List two systemic disorders that can lead to abnormal uterine bleeding.

Systemic disorders that can cause abnormal uterine bleeding include hepatic disorders and thyroid dysfunction. Hypertension and blood dyscrasias are also contributing factors. Signup and view all the answers

Explain what iatrogenic causes of abnormal uterine bleeding can include.

Iatrogenic causes of abnormal uterine bleeding can include treatments with exogenous hormones, such as estrogen. These interventions can disrupt normal menstrual patterns. Signup and view all the answers

What is the effect of increased prostaglandin E2 relative to PGF2α on fibrinolytic activity in the endometrium?

Increased prostaglandin E2 and decreased PGF2α lead to increased fibrinolytic activity in the endometrium, often observed in women with menorrhagia. Signup and view all the answers

How does prolonged estrogen without progesterone contribute to endometrial hyperplasia?

Prolonged exposure to estrogen without progesterone leads to unopposed estrogen action, causing endometrial hyperplasia. Signup and view all the answers

What role does estrogen play in the pituitary gland's feedback mechanism during cystic glandular hyperplasia?

High levels of estrogen fail to provide feedback inhibition on the pituitary gland, resulting in continued FSH secretion. Signup and view all the answers

What are the expected characteristics of bleeding associated with decreased estrogen levels?

Bleeding due to decreased estrogen levels is typically heavy, prolonged, and irregular. Signup and view all the answers

Explain the relationship between amenorrhea and prolonged estrogen action in the context of cystic glandular hyperplasia.

Amenorrhea occurs during the period of prolonged estrogen action since progesterone is absent, leading to an imbalance in menstrual regulation. Signup and view all the answers

What is oligomenorrhea and how is it defined in terms of menstrual cycle length?

Oligomenorrhea is defined as having a menstrual cycle that is longer than 35 days. Signup and view all the answers

At what average age does menarche typically occur?

Menarche typically occurs at an average age of 12 years. Signup and view all the answers

Describe the changes that occur during perimenopause and the average age range for this phase.

Perimenopause refers to the transitional period leading up to menopause, occurring around age 40 until the average menopause age of 51. Signup and view all the answers

What are some common contraceptive methods mentioned, and which ones are classified as hormonal?

Common contraceptive methods include progestins contraception, injectable steroids, and intrauterine devices, with progestins and injectables being hormonal methods. Signup and view all the answers

What is menorrhagia and how is it characterized in terms of menstrual flow?

Menorrhagia, or heavy menstrual bleeding (HMB), is characterized by excessively heavy or prolonged menstrual periods. Signup and view all the answers

What demographic is most commonly associated with the growth of endometrial blood supply?

Females who are obese and between menarche and menopause. Signup and view all the answers

What age range does the term 'between menarche and menopause' refer to?

Typically from the onset of menstruation in adolescence until the cessation of menstruation in late middle age. Signup and view all the answers

What symptom might a female in this demographic complain of regarding endometrial health?

She may complain of irregular menstruation or heavy menstrual bleeding. Signup and view all the answers

Why is obesity a significant factor in understanding endometrial blood supply?

Obesity can increase estrogen levels, leading to increased endometrial growth and vascularization. Signup and view all the answers

How might the growth of endometrial blood supply impact a woman's health?

It can increase the risk of endometrial hyperplasia and possibly lead to endometrial cancer. Signup and view all the answers

What is the role of cervical cytology in diagnosing abnormal uterine bleeding?

Cervical cytology helps detect cervical cancer or precancerous conditions that may contribute to abnormal uterine bleeding. Signup and view all the answers

How is treatment for abnormal uterine bleeding determined?

Treatment is tailored based on the underlying cause of the abnormal uterine bleeding. Signup and view all the answers

What is the significance of the HVS in conjunction with cervical cytology?

The HVS (high vaginal swab) is significant for identifying infections or inflammatory conditions that may cause abnormal bleeding. Signup and view all the answers

What does 'endometrial treatment' refer to in the context of abnormal uterine bleeding?

Endometrial treatment refers to procedures aimed at addressing issues related to the lining of the uterus that cause abnormal bleeding. Signup and view all the answers

Why is it important to differentiate between various causes of V in the context of diagnosis?

Differentiating causes is crucial for selecting the appropriate treatment and management strategy for each patient. Signup and view all the answers

Study Notes

Abnormal Bleeding Patterns

Polymenorrhea (epimenorrhea): Menstrual cycles shorter than 21 days.
Menorrhagia (hypermenorrhea): Heavy menstrual flow (over 80 ml) lasting more than 7 days, with regular cycles.
Metrorrhagia: Irregular bleeding between periods.
Polymenorrhagia: Excessive and frequent menstrual bleeding, occurring in cycles.
Menometrorrhagia: Heavy and irregular menstrual bleeding.

Causes of Abnormal Uterine Bleeding

Genital tract (Local Causes): Trauma, infections, tumors, polyps, and other abnormalities in the reproductive organs.
Psychological Causes: Stress, anxiety, and depression.
Systemic Disorders: Hepatic diseases, thyroid disorders, hypertension, blood dyscrasias, pregnancy, ectopic pregnancy, and hormonal imbalances.
Iatrogenic: Side effects of medications like oral contraceptives, progestins, injectable steroids, aspirin, heparin, warfarin, tamoxifen, and intrauterine devices.

Oligomenorrhea & Hypomenorrhea

Menstrual cycles shorter than 3 days or longer than 35 days.

Menopause & Postmenopausal Bleeding

Menopause: The cessation of menstruation.
Postmenopausal Bleeding: Any bleeding from the vagina after menopause.
Perimenopause: The transition period leading up to menopause, typically starting around age 40.

Heavy Periods (Menorrhagia)

Prostaglandin imbalances can contribute to heavy bleeding due to vasodilation and contraction of blood vessels.
Increased fibrinolytic activity in the endometrium can lead to bleeding.

Cystic Glandular Hyperplasia

Excess estrogen production without feedback inhibition from the pituitary gland leads to continued FSH secretion and high estrogen levels.
This can cause endometrial hyperplasia and heavy, prolonged, irregular bleeding due to declining estrogen levels.

Female Presentation

When a woman presents with abnormal uterine bleeding, important elements of the medical history include age, menstrual history, medication history, and any past relevant diagnoses.
Diagnostic procedures may include cervical cytology (Pap smear and HPV testing) and endometrial biopsy.

Treatment

Treatment for abnormal uterine bleeding depends on the underlying cause.

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Description

This quiz covers various abnormal bleeding patterns such as polymenorrhea, menorrhagia, and metrorrhagia. It also explores the different causes of abnormal uterine bleeding, including local, psychological, and systemic disorders. Test your knowledge on these critical reproductive health topics!