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16.04.20 disordersofmenstruation.pptx
This document provides information about disorders of the menstrual cycle. It discusses amenorrhea, which is the absence of menstrual periods, and outlines its various causes including natural states, contraceptive use, medications, lifestyle factors, and hormonal or structural issues. Signs and symptoms of amenorrhea are described. The diagnostic process and treatment options for restoring normal menstruation are also outlined. The document then discusses premenstrual syndrome, including common symptoms, potential causes, and treatment approaches like antidepressants, NSAIDs, diuretics, and lifestyle modifications.
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16.04.20 disordersofmenstruation.pptx
- 1. Program: B.Sc Nursing,3rd Year BNSG-501 MSN Unit No.4. Topic- Disorders of Menstrual Cycle Lecture No. 8 Dr. Sudharani B Banappagoudar Professor, SONS/OBG 1 BNSG 501
- 2. Outline Introduction Learningoutcomes Exercise References 2 BNSG 501
- 3. TOPIC-REPRODUCTIVE TRACT ANAMOLIES INTRODUCTION FEMALEREPRODUCTIVE SYSTEM INDIFFERENT EMBRYO DEVELOPMENT OF GENITAL DUCTS 3 <SELO: 1,3,4,6,8,10,20> <Reference No.: R1,R3> BNSG 501
- 4. Objectives • The studentwill be able to Explain • Introduction Female reproductive system Indifferent embryo Development of genital ducts 4 <SELO: 1,3,4,6,8,10,20> <Reference No.: R1,R2> BNSG 501
- 6.
- 7. • Amenorrhoea isthe absence of a menstrual period in a woman of reproductive age.
- 8. • Physiological statesof amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding), the latter also contraception known as forming the basis of a form of the lactational amenorrhoea method. • Outside of the reproductive years there is absence of menses during childhood and after menopause.
- 9. • Primary amenorrhoea(menstrual cycles never starting) may be caused by developmental problems such as, • the congenital absence of the uterus, • failure of the ovary to receive or maintain egg cells.
- 10. • It isdefined as an absence of secondary sexual characteristics by age 14 with no menarche or normal secondary sexual characteristics but no menarche by 16 years of age.
- 11. • Secondary amenorrhoea(menstrual cycles ceasing) is often caused by hormonal disturbances from the hypothalamus and the pituitary gland, from premature menopause or intrauterine scar formation. • It is defined as the absence of menses for three months in a woman with previously normal menstruation or nine months for women with a history of oligomenorrhoea.
- 12. 1. Natural amenorrhea •During the normal course of life, women may experience amenorrhea for natural reasons, such as: • Pregnancy • Breast-feeding • Menopause
- 13. 2. Contraceptives • Somewomen who take birth control pills may not have periods. Even after stopping oral contraceptives, it may take some time before regular ovulation and menstruation return. Contraceptives that are injected or implanted also may cause amenorrhea, as can some types of intrauterine devices.
- 14. 3. Medications • Certainmedications can cause menstrual periods to stop, including some types of: • Antipsychotics • Cancer chemotherapy • Antidepressants • Blood pressure drugs • Allergy medications
- 15. 4. Lifestyle factors •Sometimes lifestyle factors contribute to amenorrhea, for instance: • Low body weight. Excessively low body weight — about 10 percent under normal weight — interrupts many hormonal functions in your body, potentially halting ovulation. Women who have an eating disorder, such as anorexia or bulimia, often stop having periods because of these abnormal hormonal changes.
- 16. • Excessive exercise.Women who participate in activities that require rigorous training, such as ballet, may find their menstrual cycles interrupted. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high energy expenditure.
- 17. • Stress. Mentalstress can temporarily alter the functioning of your hypothalamus — an area of your brain that controls the hormones that regulate your menstrual cycle. Ovulation and menstruation may stop as a result. Regular menstrual after your periods usually resume stress decreases.
- 18. 5. Hormonal imbalance •Many types of medical problems can cause hormonal imbalance, including: • Polycystic ovary syndrome (PCOS). PCOS causes relatively high and sustained levels of hormones, rather than the fluctuating levels seen in the normal menstrual cycle.
- 19. • Thyroid malfunction.An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) can cause menstrual irregularities, including amenorrhea.
- 20. • Pituitary tumor.A noncancerous (benign) tumor in your pituitary gland can interfere with the hormonal regulation of menstruation.
- 21. • Premature menopause.Menopause usually begins around age 50. But, for some women, the ovarian supply of eggs diminishes before age 40, and menstruation stops.
- 22. 6. Structural problems •Problems with the sexual themselves also can organs cause amenorrhea. Examples include: • Uterine scarring. Asherman's syndrome, a condition in which scar tissue builds up in the lining of the uterus, can sometimes occur after a dilation and curettage (D&C), cesarean section or treatment for uterine fibroids. Uterine scarring prevents the normal buildup and shedding of the uterine lining.
- 23. • Lack ofreproductive organs. Sometimes problems arise during fetal development that lead to a girl being born without some major part of her reproductive system, such as her uterus, cervix or vagina. Because her reproductive system didn't develop normally, she can't have menstrual cycles.
- 24. • Structural abnormalityof the vagina. An obstruction of the vagina may prevent visible menstrual bleeding. A membrane or wall may be present in the vagina that blocks the outflow of blood from the uterus and cervix.
- 25. • The mainsign of amenorrhea is the absence of menstrual periods. Depending on the cause of amenorrhea, you might experience other signs or symptoms along with the absence of periods, such as: • Milky nipple discharge • Hair loss
- 26. • Headache • Visionchanges • Excess facial hair • Pelvic pain • Acne • Vaginal dryness • Night sweats
- 27. • History collection •Physical examination • Blood tests may be performed to determine the levels of hormones secreted by the pituitary gland (FSH, LH, TSH, and prolactin) and the ovaries (estrogen).
- 28. • Ultrasonography ofthe pelvis may be performed to assess the abnormalities of the genital tract or to look for polycystic ovaries. • CT scan or MRI of the head may be performed to exclude pituitary and hypothalamic causes of amenorrhea.
- 29. • If theabove tests are inconclusive, additional tests may be performed including: • Thyroid function tests • Determination of prolactin levels • Hysterosalpingogram (X-ray test) which examine the uterus • Hysteroscopy
- 30. • Dopamine agonistssuch as bromocriptine (Parlodel) or pergolide (Permax), are effective in treating hyperprolactinemia. In most women, treatment with dopamine agonists medications restores normal ovarian endocrine function and ovulation. • Hormone replacement therapy consisting of an estrogen and a progestin can be used for women in whom estrogen deficiency remains because ovarian function cannot be restored.
- 31. • Metformin (Glucophage)is a drug that has been successfully used in women with polycystic ovary syndrome to induce ovulation.
- 32. • In somecases, oral contraceptives may be prescribed to restore the menstrual cycle and to provide estrogen replacement to women with amenorrhea who do not wish to become pregnant. • Before administering oral contraceptives, withdrawal bleeding is induced with an administration of 5-10 mg injection of progesterone or oral of 10 medroxyprogesterone (Provera) for days.
- 33. • Some pituitaryand hypothalamic tumors may require surgery and, in some cases, radiation therapy. • Women with intrauterine adhesions require dissolution of the scar tissue.
- 34.
- 35. • Premenstrual syndrome(PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding.
- 36. • Common symptomsinclude acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Often symptoms are present for around six days. • Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that has greater psychological symptoms.
- 37. • Exactly whatcauses premenstrual syndrome is unknown, but several factors may contribute to the condition: • Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
- 38. • Chemical changesin the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.
- 39. Emotional andbehavioral symptoms • Tension or anxiety • Depressed mood • Crying spells • Mood swings and irritability or anger
- 40. • Appetite changesand food cravings • Trouble falling asleep (insomnia) • Social withdrawal • Poor concentration
- 41. Physical signs andsymptoms • Joint or muscle pain • Headache • Fatigue • Weight gain related to fluid retention • Abdominal bloating • Breast tenderness • Acne • Constipation or diarrhea
- 42. are no uniquephysical or laboratory tests to diagnose premenstrual • There findings positively syndrome.
- 43. • Antidepressants. Selectiveserotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or PMDD. These drugs are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.
- 44. • Nonsteroidal anti-inflammatory drugs(NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, Naprosyn, others) can ease cramping and breast discomfort.
- 45. • Diuretics. Whenexercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.
- 46. • Hormonal contraceptives.These prescription medications stop ovulation, which may bring relief from PMS symptoms.
- 47. • Eat smaller,more-frequent meals to reduce bloating and the sensation of fullness. • Limit salt and salty foods to reduce bloating and fluid retention. • Choose foods high in complex carbohydrates, such as fruits, vegetables and whole grains. • Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, a daily calcium supplement may help. • Avoid caffeine and alcohol.
- 48. • Engage inat least 30 minutes of brisk walking, cycling, swimming or other aerobic activity most days of the week. Regular daily exercise can help improve your overall health and alleviate certain symptoms, such as fatigue and a depressed mood.
- 49. • Get plentyof sleep. • Practice progressive muscle relaxation or deep-breathing exercises to help reduce headaches, anxiety or trouble sleeping (insomnia). • Try yoga or massage to relax and relieve stress.
- 50. • Keep arecord to identify the triggers and timing of your symptoms. This will allow you to intervene with strategies that may help to lessen them.