Reproductive Hormones and Menstrual Cycle
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Questions and Answers

What is a common cause of menorrhagia in girls during menarche?

  • High estrogen levels
  • Shortened follicular phase
  • Defect in the corpus luteum
  • Immaturity of the hypothalamic-pituitary-ovarian axis (correct)
  • What is a result of high estrogen levels?

  • Menometrorrhagia (correct)
  • Menorrhagia
  • Ovulatory cycles
  • Amenorrhea
  • What is the treatment for luteal phase insufficiency?

  • Inducing ovulation with FSH
  • Performing a hysterectomy
  • Giving progesterone to regulate the cycle (correct)
  • Giving estrogen to regulate the cycle
  • What is a characteristic of patients with PCOS?

    <p>Regular menstrual cycles with few ovulatory and anovulatory cycles</p> Signup and view all the answers

    What is a result of ovulation with lowered progesterone levels?

    <p>Spotting or intermenstrual bleeding</p> Signup and view all the answers

    What is a common cause of frequent miscarriages?

    <p>Luteal phase insufficiency</p> Signup and view all the answers

    What is the duration of absent bleeding required to be classified as amenorrhea?

    <p>&gt;6 months</p> Signup and view all the answers

    What is the primary cause of DUB?

    <p>Hormonal changes leading to anovulation</p> Signup and view all the answers

    What occurs in anovulatory cycles?

    <p>Continuous estrogen production with no corpus luteum formation</p> Signup and view all the answers

    What is the result of estrogen unopposed by progesterone?

    <p>Endometrial hyperplasia</p> Signup and view all the answers

    During which life stages can anovulatory cycles be seen?

    <p>Both in adolescents after menarche and in perimenopausal years</p> Signup and view all the answers

    What would happen to the corpus luteum if pregnancy takes place?

    <p>It would remain and secrete progesterone</p> Signup and view all the answers

    What is the primary indicator of ovulation during the mid-cycle?

    <p>Increased LH levels</p> Signup and view all the answers

    What is the typical duration of normal menstruation?

    <p>2-7 days</p> Signup and view all the answers

    What is the term for heavy or prolonged menstrual bleeding at regular intervals?

    <p>Menorrhagia</p> Signup and view all the answers

    What is the term for bleeding in irregular intervals and more frequently than normal?

    <p>Metrorrhagia</p> Signup and view all the answers

    What is the term for a combination of heavy bleeding at irregular intervals and more frequently?

    <p>Menometrorrhagia</p> Signup and view all the answers

    What is the term for spotting of blood in between menstrual cycles?

    <p>Intermenstrual bleeding</p> Signup and view all the answers

    What is the first step in diagnosing a patient with abnormal bleeding?

    <p>Order an abdominal or transvaginal ultrasound</p> Signup and view all the answers

    What is the normal endometrial thickness in reproductive ages?

    <p>15-16 cm</p> Signup and view all the answers

    What is the diagnosis if the endometrial thickness is 10-12 cm and the patient is amenorrheic?

    <p>Endometrial hyperplasia</p> Signup and view all the answers

    What must be excluded in any patient presenting with abnormal uterine bleeding?

    <p>Normal pregnancy, early or ectopic pregnancy, and miscarriage</p> Signup and view all the answers

    Where can adenomyosis occur in the uterus?

    <p>In different locations within the uterus</p> Signup and view all the answers

    What is the expected endometrial thickness after menstruation?

    <p>5-6 cm</p> Signup and view all the answers

    What is the primary purpose of performing a pap smear?

    <p>Screening for cervical cancer</p> Signup and view all the answers

    What is the primary method used to visualize the vagina, cervix, and ovaries?

    <p>Transvaginal ultrasound</p> Signup and view all the answers

    What is the purpose of performing an endometrial biopsy?

    <p>To identify abnormal endometrial cells</p> Signup and view all the answers

    What is the role of hysteroscopy in D&C?

    <p>To visualize the cervical canal during the procedure</p> Signup and view all the answers

    When can a pap smear be performed?

    <p>As a regular screening test every 3 years</p> Signup and view all the answers

    What is the purpose of D&C?

    <p>To treat overgrowth in the uterus</p> Signup and view all the answers

    Study Notes

    Amenorrhea and Abnormal Bleeding

    • Amenorrhea is defined as no bleeding for more than 6 months, while absent bleeding for 2-3 months is not considered amenorrhea.

    Dysfunctional Uterine Bleeding (DUB)

    • DUB can be caused by anovulatory or ovulatory factors.
    • Anovulatory DUB is characterized by continuous estrogen production with no corpus luteum, leading to no progesterone production.
    • Anovulatory cycles are common in adolescents during menarche and in perimenopausal years due to declining hormone levels.

    Anovulation

    • In anovulation, there is continuous estrogen release (E2) with no ovulation, leading to growth of endometrial lining and potentially causing endometrial hyperplasia.
    • Measuring mid-cycle LH levels can help diagnose ovulation.

    Definitions

    • Normal menstruation: 2-7 days, 21-35 days between periods, and blood loss of less than 80ml.
    • Menorrhagia: heavy or prolonged menstrual bleeding, often requiring more pads.
    • Metrorrhagia: bleeding at irregular intervals, more frequently than normal.
    • Menometrorrhagia: a combination of heavy and irregular bleeding.
    • Intermenstrual bleeding: spotting of blood between menstrual cycles, often due to thickened endometrium.

    Ovulatory DUB

    • Ovulatory DUB is caused by a defect in the corpus luteum, leading to prolonged progesterone production, spotting, or intermenstrual bleeding.
    • This can cause frequent miscarriages, and treatment involves regulating the cycle with progesterone.

    Endocrine Causes

    • Endocrine causes are the most important to exclude, particularly in patients with PCOS.
    • Patients with PCOS may have regular menstrual cycles with few ovulatory and anovulatory cycles.

    Diagnosis

    • Abdominal or transvaginal ultrasound are commonly used to diagnose abnormal bleeding.
    • Endometrial thickness should be measured, especially in amenorrheic patients, to diagnose endometrial hyperplasia.
    • Hysteroscopy and dilation of the cervix may be used for biopsy and treatment.

    Other Diagnostic Tools

    • Pap smear is used to screen for cervical cancer.
    • D&C and hysteroscopy can be diagnostic and therapeutic.
    • Transvaginal ultrasound is commonly used to diagnose abnormalities in the vagina, cervix, and ovaries.

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    Description

    Learn about the changes in hormone levels throughout the menstrual cycle, including LH and FSH, and how they relate to ovulation and pregnancy. Understand the different phases of the cycle and how to calculate the last menstrual period.

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