Disorders of Female Reproductive System (38)

Typical menstrual cycle

28 days (any bleeding signifies the first day... even spotting)

When does ovulation occur?

About 14 days BEFORE the beginning of the next period

Menarche

Beginning of menstruation

Two phases of ovarian cycle

Follicular phase
Luteal Phase

Follicular phase

First 14 days, FSH and LH stimulate the maturation of ova in prep for fertilization.

Estrogen peaks when ova is released (ovulation)

Luteal Phase

Days 15-28, LH and progesterone, blood supply in uterus increases in prep for fertilized ovum.

If fertilization does not occur, lining of the uterus is shed

Normal blood loss during period

40-80 mL

Premenstrual dysphoric disorder (PMDD)

Extreme PMS (suicidal thoughts, despair, tears, panic, anxiety)

- Diagnosed based on symptoms in a pattern through more than three months

Primary vs secondary dysmenorrhea

Primary = caused by hormones
Secondary = caused by something else (PID, endo)

Interventions to help dysmenorrhea

• Heating pad

• effleurage (gently massaging abd)

• low fat diet

• pelvic rock exercises

• NSAIDS

• Foods that are natural diuretics (cranberry juice, asparagus, watermelon)

Menorrhagia

Heavy periods

Bacterial vaginosis

caused by imbalance of normal flora
- thin grey discharge, fishy odor

yeast infection

caused by candida

• thick white discharge

• redness, itching

Primary vs secondary infertility

primary = inability to conceive after 1 year of unprotected sex
secondary = inability to conceive after having a child already

Can high temps of scrotum cause infertility?

Yes
- avoid saunas

What percentage of people have infertility

10.9% or 6.7 million

Menopause definition

No period for 12 months
- caused by decrease in estrogen production

Pre-menopause

Gradual decrease of hormones

• irregular menses

• vaginal dryness

• hot flashes

• night sweats

Health risks of menopause

• osteoporosis (decrease in estrogen slows bone growth)

• Coronary heart disease (changes in lipid metabolism causing increase cholesterol)

When should breast self exams be done?

1 week after menses begin

Diet for women with hot flashes

soy, tofu, flax, cherries, yams, black beans

You should not wear deodorant to a mammogram true or false

true

What age do mammograms typically begin?

40 q yearly

How often and when should provider breast exams be preformed?

Every three years during 20-30s

How often are pap tests performed?

- every three years starting at 21

Toxic shock syndrome

• Caused by trapping bacteria in the reproductive tract for long periods (tampons)

• High fever

• Dizziness, headache

• hypotension

• rash that looks like sunburn

CHANGE tampons every 4 hours

Cervical cancer

Usually asymptomatic

• pap smear shows positive

• colposcopy is definitive

Risk increases with

• many sex partners

• multiple pregnancies

• Hx of HPV or STI

HPV vaccine

Recommended for all ages 9-26
- can help prevent certain cancers associated with HPV

Ovarian Cancer

Silent cancer

• asymptomatic until advanced

• Increased abd girth, feeling full when eating, urge to urinate

Fibroadenoma

- Firm, rubbery, mobile nodules
-typically no change during period

Fibrocystic breast changes

• Thickening of portions of breast tissues

• Worse with period

Eliminate alc and caffeine

• reduce fat

• NSAIDS

• Vit E supplements

Multiple lumps

Intraductal papilloma

• Small epithelial elevations in the ducts of the breast

• can cause nipple discharge

Risk factors for breast cancer

• Early periods

• Late menopause (more estrogen exposure)

• women on hormone replacement therapy as well

Types of benign tumors in female reproductive system

• fibroids

• Polyps

• Ovarian cysts

• PCOS

Salping

Fallopian tube related

Oophor

Ovary related

Periton

Peritoneum related

Pelvic inflammatory disease (PID)

• Can be caused by STI but not always

• Can cause infertility due to fallopian tube damage

S/s = pelvic pain, chandelier sign (pain with cervical manipluation)