Common Reproductive System Concerns

Amenorrhea

Absence of menses

Amenorrhea: Primary 1

absence of menses by the age of 15 without any growth or developing of secondary sexual characteristics

Amenorrhea: Primary 2

absence of menses by the age of 16 with the growth and development of secondary sexual characteristics

Amenorrhea: Secondary

Is the absence of a menses for 3 months or irregular menses for at least 6 months (with a regular cycle prior)

Amenorrhea: Diagonosed

history and physical exam

Amenorrhea: Treatment

based on the underlying cause

Dysmenorrhea

Painful menstruation

Dysmenorrhea: Primary

Painful cramps without a cause

Dysmenorrhea: Secondary

Pelvic and uterine pathology, Endometriosis

Nursing Management of Dysmenorrhea

Get a well detailed medical history including sexual history and menstrual history

Nursing Management of Dysmenorrhea: manifestation 

pain, nausea, vomiting, diarrhea, fatigue, fever, headaches, dizziness

Nursing Management of Dysmenorrhea: Education

comfort measures

Abnormal Uterine Bleeding

Painless endometrial bleeding that is prolonged, excessive , and irregular that is not connected to any systemic disease or structural disease

Abnormal Uterine Bleeding: cause

related to hormone disturbance

Abnormal Uterine Bleeding: common occurance in

beginning and end of reproductive years

Abnormal Uterine Bleeding: treatment

involves treating the underlying cause

Abnormal Uterine Bleeding: Therapeutic management

normalize the bleeding, correct the anemia,
prevent or diagnose early cancer, and restore quality of life

Abnormal Uterine Bleeding: Pharmacotherapy

insertion of a hormone-secreting intrauterine system

Abnormal Uterine Bleeding: Surgical intervention

dilation and curettage (d&c), endometrial ablation, uterine artery embolization, or hysterectomy

Premenstrual Syndrome (PMS)

Wide range of recurrent symptoms

Premenstrual Syndrome (PMS): Most severe

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD): cause

Cause is unknown

Premenstrual Dysphoric Disorder (PMDD): therapeutic management

Lifestyle changes and/or medications

Premenstrual Syndrome (PMS): Nursing Assessment

anxiety, Cravings, Depression, Hydration, other (ACDHO)

Main symptoms of PMDD involve

Mood disorders

PMS: ACOG Critria

most have these symtoms 5 days period for 3 cycles: Mood/physical symptoms

PMS: Mood symptoms

depression, anxiety, irritability, etc..

PMS: Physical symptoms

bloating, headache, breast tenderness

Endometriosis: Cause

unknown but there are risk factors

Endometriosis: Therapeutic management

Surgey, Medication therapy

Endometriosis: Nursing assessment

Infertility and pain, nonspecific pelvic tenderness; tender nodular masses on uterosacral ligaments, posterior uterus

Endometriosis: Nursing management

Education, Healthy lifestyle habits, Support groups

Fertility Assessment: Male

Semen analysis, sexual characteristics, external and internal exams of reproductive organs, prostate exam

Fertility Assessment: Female

Ovarian function, pelvic organs exam

Fertility Assessment: Lab and diagnostic

Home ovulation test, clomiphene citrate challenge test, hysterosalpingogram,
laparoscopy

Nursing Management of Infertility

Show respect for the couple, Educate, stress management, counseling, anticipatory guidance, Assistance in decision-making; advocacy, Assistance with financial planning

Contraception: Behavioral Methods

Abstinence, Fertility awareness, Withdrawal, Lactational amenorrhea method

Fertility awareness

Cervical mucus ovulation method, Basal body temperature, Symptothermal method, Standard days method

Contraception: Barrier Methods

Condoms, Diaphragm, Cervical cap, Contraceptive sponge

Contraception: Hormonal Methods

Oral contraceptives, Injectable contraceptives, Transdermal patches, Vaginal rings, Implantable contraceptives, Intrauterine contraceptives, Emergency contraception

Contraception: Sterilization

Tubal Ligation, Vasectomy

Tubal Ligation

Sterlization for women, A laproscope is inserted; fallopian tubes are grasped and sealed

Vasectomy

Sterlization for men, Performed under local, The vas deferens is cut which carries the sperm

Surgical Abortion

vacuum aspiration or dilation and evacuation (determined by age)

Medical Abortion

Most common is Mifepristone (blocks progesterone) followed by Misoprostol 24-48hrs later .

Menopause on the Body: Brain

hot flashes; sleep, mood and memory problems

Menopause on the Body: Heart

lower levels of HDL; increased risk of CVD

Menopause on the Body: Bones

bone density loss; increased risk of osteoporosis

Menopause on the Body: Breast

duct and gland tissue replaced by fat

Menopause on the Body: Genitourinary

vaginal dryness, stress incontinence, cystitis

Menopause on the Body: Gastrointestinal

less CA+ absorbed; increased fractures

Menopause on the Body: Skin

dry skin, collagen decreases

Menopausal Transition: Nursing assessment

Screening for osteoporosis, cardiovascular disease, and cancer risk
(strategies to prevent chronic conditions)

Menopausal Transition: Nursing Management

Health maintenance education; reducing risks, Lifestyle modifications, Stress management