Menstrual Disorders and Conditions Quiz

Female Reproductive Disorders

• Female Reproductive System Functions: Formation of ova, reception of spermatozoa, environments for fertilization/fetal development, childbirth, and lactation.

External Genitalia (Vulva)

• Components: Labia majora, labia minora, clitoris, vaginal orifice, vestibule, hymen, and vestibular glands (Bartholin's glands).

Internal Genitalia

• Components: Vagina, uterus, fallopian tubes, ovaries.
• Uterus Structure: Perimetrium (outer), myometrium (middle muscle), endometrium (inner lining).
• Uterus Parts: Fundus, body, cervix.
• Vagina: Fibromuscular tube, stratified squamous epithelium, oblique course between bladder/rectum.
  • Functions: Receives penis, childbirth passageway

Uterine (Fallopian) Tubes

• Length and location: 10 cm long, extend from sides of uterus.
• Fimbriae: Finger-like projections at the end of each tube.
• Functions: Propel ovum to uterus via peristalsis/ciliary movement; nourish ovum/spermatozoa. Fertilization usually occurs in tube, then zygote travels to uterus for implantation.

Ovary Structure

• Tunica albuginea: Fibrous capsule.
• Cortex: Outer; houses oocytes (developing gametes) within follicles.
• Medulla: Inner; loose connective tissue, blood vessels & nerves.

Ovarian Cycle

• Follicular phase: ~14 days, variable, egg develops in follicle (most follicles die). FSH stimulates follicle growth, a single follicle matures into a Graafian follicle. Estrogen produced from follicle stimulates release of LH.
• Ovulation: Egg released from follicle (LH surge), egg enters abdominal cavity and is picked up by fimbriae of the fallopian tube.
• Luteal phase: ~14 days, constant, exploded follicle becomes Corpus Luteum. Produces progesterone & estrogen. Progesterone prepares uterus for pregnancy. If no pregnancy, Corpus Luteum degenerates into Corpus Albicans.

Menstrual Disorders

• Abnormal Uterine Bleeding (AUB): Irregular bleeding due to hormonal changes during menstruation.
  • Types: Polymenorrhea (more frequent cycles), metrorrhagia (bleeding between periods), menorrhagia (prolonged/excessive during periods), menometrorrhagia (increased blood loss, frequent/irregular), oligomenorrhea (reduced flow), amenorrhea (absence of flow).

Amenorrhea

• Primary Amenorrhea: Never had a menstrual period.
• Secondary Amenorrhea: Menstrual periods started, then stopped.
• Causes (Primary): Genetics, congenital disorders, malnutrition, hyperthyroidism
• Causes (Secondary): Pregnancy, breastfeeding, menopause, PCOS, emotional upset, excessive exercise, medications.

Dysmenorrhea

• Painful Menstrual Periods: Common in nulliparous women. Pain in lower torso (pelvis), severe a few days before and during period. More severe if periods started young, are long/heavy, or if family members have dysmenorrhea.

Types of Dysmenorrhea

• Primary: No identifiable pelvic pathology, likely due to increased prostaglandins during menstruation.
• Secondary: Underlying pathology (e.g., endometriosis, fibroids, adenomyosis, birth defects, cysts, tumors, PID, IUD).

Premenstrual Syndrome (PMS)

• Symptoms: Physical (headache, fatigue), behavioral (irritability), and emotional (mood swings). Varies between women and cycles

Premature Menopause

• Definition: Permanent end of menstrual periods before age 40.
• Causes: Ovaries stop releasing eggs & producing hormones.
• Symptoms: Similar to natural menopause (hot flashes, etc.) but absence of symptoms is possible.

Uterine Prolapse

• Definition: Uterus drops down into vagina due to weakened connective tissue/ligaments.
• Stages: I (upper half of vagina), II (nearly to vaginal opening), III (protrudes out of vagina).
• Symptoms: Pain, difficulty with bowel movements, painful intercourse, feeling of heaviness/pressure.

Cystocele & Rectocele

• Cystocele: Bladder drops towards vaginal opening; damage to anterior vaginal support.
• Rectocele: Rectum bulges into vagina due to weakened tissue/ligaments between rectum and vagina.

Fistulas

• Definition: Abnormal opening btwn internal hollow organs.
  • Types: Vesicovaginal (bladder-vagina, urine from vagina), Rectovaginal (rectum-vagina, fecal incontinence), Cervical, Enterovaginal.

Infertility

• Definition: Inability to conceive after one year of unprotected intercourse.
  • Types: Primary (never had a child), Secondary (at least one conception).
    • Causes: Uterine displacement, congenital anomalies, inflammation, STDs, impaired sperm production

Ectopic Pregnancy

• Definition: Pregnancy occurs outside uterine cavity (e.g., fallopian tube).
• Symptoms: Light bleeding, pelvic pain (severe if rupture), nausea, vomiting, abdominal cramp, shoulder/neck pain, dizziness/weakness.

Abortion

• Definition: Termination of pregnancy before viability.
  • Types: Spontaneous (natural), Induced (therapeutic/elective).
  • Stages: Threatened, inevitable, incomplete, complete, missed, habitual.

Hydatidiform Mole

• Definition: Abnormal growth (mass) in the uterus, type of gestational trophoblastic disease (GTD).
  • Types: Partial (abnormal placenta, some fetal development), Complete (abnormal placenta, no fetus).
    • Symptoms: Vaginal bleeding, elevated human chorionic gonadotropin levels, fundal height greater than expected for gestation date, snowstorm pattern on ultrasound.

Breast Cancer

• Types: Ductal (commonest) or lobular.
• Metastasis: Through lymph nodes.
• Grading: I (mild dysplasia), II (moderate), III (severe), IV (anaplasia).
• Staging: 0-IV (0: in situ, 1-IV: increasing local/regional spread/distant metastasis).

Ovarian Cysts

• Definition: Fluid-filled sac on an ovary.
  • Types: Functional (common, cycle-related), Pathologic (abnormal cell growth).
    • Symptoms: Pelvic pain (ranging in intensity), dyspareunia, bowel problems, urinary frequency, abnormal periods, bloating.

Uterine Fibroids

• Definition: Benign tumors in the uterine wall (common in women of reproductive age).
  • Classification: Intramural (in wall), submucosal (into cavity), subserosal (out of surface).
• Symptoms: Heavy bleeding, longer periods, pelvic pressure/pain, frequent urination, constipation, back/leg pain.
• Treatment: Myomectomy, myolysis, hysterectomy

Polycystic Ovarian Syndrome (PCOS)

• Definition: Endocrine disorder impacting menstrual cycles and hormone levels (high androgens).
• Symptoms: Irregular periods, acne, voice changes, reduced breast size, hirsutism (excess body hair), may be slightly obese or thin.
• Diagnosis: Hormone levels, ultrasound.
• Treatment: Exercise, diet, drugs (metformin, birth control pills, spironolactone, anti-androgens). Surgery as a final resort when other treatments fail

Cervical Cancer

• Definition: Cancer of the cervix
• Causes: HPV infection, other risk factors including STDs, immunosuppression, poor diet, obesity, early/multiple pregnancies, smoking
• Pathophysiology:
  • Preinvasive: Minimal/severe dysplasia, carcinoma in situ
  • Invasive: Penetration of basement membrane w/ spread to adjacent pelvic structures, lymph system.
• Staging: 0-IV to determine treatment
• Treatment: Surgery, Radiation, Chemotherapy

Endometrial (Uterine) Cancer

• Definition: Cancer of the endometrial lining of the uterus.
• Risk factors: Estrogen replacement, late onset of menopause, obesity, family history, nulliparity

Ovarian Cancer

• Definition: Cancer arising from the ovaries.
• Risk factors: Estrogen, nulliparity, PCOS, age, late menopause, family history of certain cancers, obesity, hypertension, diabetes.
• Symptoms: Abdominal discomfort/swelling, gastrointestinal issues, abnormal vaginal bleeding, abdominal mass, increased tumor marker (ex: CA-125).
• Management: Surgery (remove ovaries, uterus), Chemotherapy; radiation may be used.