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⬢ Primary amenorrhea
o Lack of menstruation and failure to menarche by age 14
⬢ Secondary amenorrhea
o Absence of menstruation for a time period of 3 or more cycles o Elevated prolactin levels (not associated with pregnancy) also can cause unusual hariness and infertility
⬢ Dysfunctional uterine bleeding
o 69% of GYN use o Cause-age, stress, and endocrine disorders  Pathophysiology o No progesterone secretion (corpus luteum) but continuous estrogen o Unopposed estrogen produces atypical hyperplasia and CARCINOMA
⬢ Polycystic ovarian syndrome
o Ovulation inhibited by production of androgens and convert to estrogen o Cause-persistent anovulation endometrial polyps and breast cancer
what out of what women PMS
8 out of ten
1 pattern of PMS
 5-7 days before onset of period and stop when period begins
pattern of pms
 Starts ovulation and lasts for 2 weeks until period (2 weeks total)
anxiety, tension, irritability and mood swings
(Hyper hydration) – water retention, abdominal bloating, breast tenderness, weight gain, swelling of feet and hands
for sweets, chocolates, headaches, fainting, heart palpations
(Depression) – depression, confusion, fatigue, crying, forgetfulness, and insomnia
premenstrual dysphoric syndrome MAIN DIFFERENCE FROM PMS  Clinical depression short cycle duration. Seen after age 25
imbalance of estrogen and progesterone. Even though they must be present to trigger PMS the hormone itself doesn’t cause the disorder
PMDD Susceptibility
 Genetic differences  Sensitivity of receptors and messenger systems for signals to cell  History of other mood disorders or serotonin function
 Healthy diet  Regular exercise plan  Vitamins – B6, A, Zinc, folic acid  Progesterone replacement
 Thyme leaf, passion flowers, wild milky seed, rosemary leaf, st. john’s worth  Prostaglandin – oil of evening primrose  Serotonergic drugs- Prozac  Oral contraceptives  Surgery
⬢ Pelvic Inflammatory Disease (PID)
o Infection involving the uterus, fallopian tubes, or ovaries o Clinical – severe abdominal pain with fever seen during or after menstruation
Vulvitis CAUSES
o Irritation by soaps, lotions, hygienic sprays, etc.
o Inflammation of ducts leading from vaginal opening caused by strept/staph infection
Cystocele CAUSED BY
CAUSED BY – women with prolonged labor and push for a long duration
– pressure from fetal head
Uterine prolapsed things that help
o Pessary – a mechanical device to hold uterus in place o Kegel exercise helps
⬢ Benign ovarian cyst o Two types
follicular cyst and corpus luteum cyst
Endometrial polyps
o Mass of endo tissue attached to uterine lining by a pedicle
⬢ Leiomyomas what is it and treatments
o Uterine fibroids o Clinical signs – abnormal uterine bleeding, pressure on related structures o Treatment – reduction with progesterone or GNRH
cervical cancer- it is very invansive cased by HPV. o Human papillomavirus
it can be increased by smoking
what is a pap smear (test)
 Cells are scrapped or brushed of the cervix and prepared on a slide.
is vaginal cancer common
no..very rare
most common Endometrial cancer
ovarian cancer is reduced by two ways what is it
pregancy and childbirth
two types of ovarain cancer
 Epithelium ovarian neoplasm  Germ cell neoplasm
o Sexual anorexia
libido and decrease sexual drive caused by beta blockers
muscle spasms caused by trauma such as rape
inability to achieve orgasm
– painful intercourse caused by antihistamine (drying effect)
o Cells similar to those which form inside the uterus are found outside the uterus o Attach to tissue and become “implants” o Generally benign o Respond to hormones of the menstrual cycle o Implants bleed internally causing tissue inflammation and scarring
causes of endomeriosis
 Unknown  Retrograde menstruation  Hereditary and immune system  Transported by circulatory system  Embryonic tissue  Lymphatic distribution
what are some symptoms of endometriosis
 Usually no symptoms  Pain and infertility  Painful intercourse  Pelvic pain during or just before menstruation  Frequent infection  Backaches  Cramping with bowel movements or urination  Inflammation and scarring causes distortion of female reproductive organs causing infertility  Lower abdominal pain  Diarrhea/constipation  Irregular/heavy menstrual bleeding
stages of endometriosis---stage 1
minimal (superficial endometriosis and filmy adhesions)
o Endometriosis Stage 2
mild (superficial and deep endometriosis and filmy adhesions)
o Endometriosis Stage III
moderate ( superficial and deep endometriosis and filmy and dense adhesions)
Endometriosis stage 4
– severe (superficial and deep endometriosis and dense adhesions)
what methods used in diagnosing enometriosis
 Nodules (implants) palpated  Direct visual inspection
treatments of endometriosis
 Pain relief- non-steroidal anti-inflammatory drugs  Motrin or Naprosyn  Dec estrogen levels  GnRH analogs – prevents natural releasing hormones from secretion  Nafarelin (Synarel) – nasal spray for 6 months  Low estrogen cause bone thinning  Leuprolide (Lupron)
o Excessive prolactin in blood o Menstrual abdnormalities
⬢ Benign breast disease information
o Fibrocystic disease o Fluctuate during menstrual cycle
Breast cancer how many women 1 out of get it
o 1 in every 7 women in the US will develop breast cancer. Risk of dying from breast cancer is much lower at 1 in 28
breast cancer is the leading cause of death in the US? true or false
no it is the second...lung cancer is the first
what are risk factors of breast cancer
genetic, age, nutrional, and hormonal
what can cause a slight increat is getting breast cancer
o Early menstrual cycles, delayed menopause and 1st pregnancy after age 30 – slight inc risk..o not breastfeeding, drinking 2-5 alcoholic drinks a day, being overweight (esp after menopause), and not exercising o High fat diets
process of diagnosing breast cancer
 Mammography and breast exam  85-90% of all cancers are detected by mammography  Breast exam- during routine checkup and monthly self exam 3 days after menstrual period has stopped  Ultrasound - Biopsy
⬢ Lobular carcinoma in Situ (LCIS) (kind of breast cancer
o Incidental finding in biopsy Stage 0 o Precancerous condition o No symptoms or characteristic features o 38% may not develop invasive cancer until more than 20 years after initial diagnosis
⬢ Ductal carcinoma in Situ (DCIS)
o Pre-invasive form of cancer- Stage 0 o No lump associated with cancer o Multifocal in nature o 40% will ultimately develop invasive breast cancer
⬢ Infiltrating Ductal Carcinoma
o 65-85% most common o Found as an irregular mass or small white irregular microcalcifications o Lump feeling harder or firmer than benign mass o Begins in milk duct and penetrates outside of the wall
o Inflammatory carcinoma
 Subtype of infiltrating ductal carcinoma  Signs – red, swollen, warm and thicken skin  Rapid growth of cancer  Spread to lymph nodes  Poor prognosis
⬢ Infiltrating Lobular Carcinoma
o 5-10% of cases o No hard mass present upon palpation just vague thickening of breast tissue o May occur in more than one site o Begins in glands as opposed to the duct
• Paget’s Disease
o 1-4% of cases o Crusting and scaling of nipple o Usually in only 1 breast
⬢ Cystosarcoma Phyllodes
o Firm tumor o Spreads via bloodstream o Women over 50
treatments of breast cancer
o Local – includes surgery and or radiation  Modified radical mastectomy – removal of breast and axially lymph nodes  Simple mastectomy – removal of breast  Lumpectomy – removal of only a portion o Systemic Therapy  Used to eradicate microscopic deposits of breast cancer cells present in other areas of the body  Chemotherapy- cyclophosphamide (Cytoxan), methotrexate, and 5-flourouracil (CMF), or Adriamycin  Six cycles over 6 months o Hormonal therapy  Anti-estrogen agent-tamoxifen  Can cause inc risk of uterine cancer  Best chance of eliminating breast cancer is prevention  A women should have a baseline mammogram between the ages of 35-40  40-50 years – one every other year  50+ - yearly

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