Scribd Logo
Unggah

Selamat datang di Scribd!

  • Menorrhagia Seminar 7

    Diunggah oleh

    mie_anum
    51 tayangan26 halaman
    Menorrhagia can be defined as a complaint of heavy cyclical menstrual blood loss over several consecutive menstrual cycles in a woman of reproductive years. 5% of women between the ages of 30 and 49 years old suffer from the condition. Symptoms include: Irregular Intermenstrual or post coital bleeding Change in symptoms Dyspareunia Pelvic or premenstrual pain excessive bleeding from other sites eg: after tooth extraction. Treatment should

    Deskripsi Asli:

    Hak Cipta

    © Attribution Non-Commercial (BY-NC)

    Format Tersedia

    PPTX, PDF, TXT atau baca online dari Scribd

    Apakah menurut Anda dokumen ini bermanfaat?

    Apakah konten ini tidak pantas?

    Laporkan Dokumen Ini
    Menorrhagia can be defined as a complaint of heavy cyclical menstrual blood loss over several consecutive menstrual cycles in a woman of reproductive years. 5% of women between the ages of 30 and 49 years old suffer from the condition. Symptoms include: Irregular Intermenstrual or post coital bleeding Change in symptoms Dyspareunia Pelvic or premenstrual pain excessive bleeding from other sites eg: after tooth extraction. Treatment should

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPTX, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    51 tayangan26 halaman

    Menorrhagia Seminar 7

    Diunggah oleh

    mie_anum
    Menorrhagia can be defined as a complaint of heavy cyclical menstrual blood loss over several consecutive menstrual cycles in a woman of reproductive years. 5% of women between the ages of 30 and 49 years old suffer from the condition. Symptoms include: Irregular Intermenstrual or post coital bleeding Change in symptoms Dyspareunia Pelvic or premenstrual pain excessive bleeding from other sites eg: after tooth extraction. Treatment should

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPTX, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 26

    Mohd Helmy B Abu Bakar

    012010050487 Year 4 MBBS-MSU

    Disorders of menstrual cycle


    Topic covered:
    1. 2. 3. 4. 5. 6. Menorrhagia Dysmenorrhea Amenorrhea/oligomenorrhea Polycystic ovarian syndrome Post menopausal bleeding Premenstrual syndrome

    Menorrhagia/Heavy menstrual bleeding

    Definition
    Menorrhagia can be defined as a complaint of heavy cyclical menstrual blood loss over several consecutive menstrual cycles in a woman of reproductive years, or more objectively, a total menstrual blood loss of more than 80 ml per menstruation

    Prevalence
    Extremely common 5% of women within the ages of 30 and 49 years old

    Atielogy
    Fibroids Endometrial polyps Coagulation disorders eg: von Willebrands disease Pelvic inflammatory disease (PID) Thyroid disease Drug therapy eg: warfarin Intrauterine contraceptive devices (IUCDs) Endometrial/ cervical carcinoma

    Uterus fibroid

    Endometrial polyp

    Clinical features
    History Hallmark of menorrhagia is complaint of regular excessive menstrual loss over several consecutive cycles Discussion of the numbers of the towels and tampons used per day (menstrual pictogram) Impact of the condition on the patients lifestyle and quality of life (severity) Duration of current problem and any other symptoms

    Other symptoms : Irregular Intermenstrual or post coital bleeding Change in symptoms Dyspareunia Pelvic or premenstrual pain Excessive bleeding from other sites eg: after tooth extraction

    Clinical examination Sign of anemia, obesity, thyroid Abdominal and pelvic examination Swabs and cervical smears

    Investigation
    1. FBC 2. Coagulation screen 3. Pelvic ultrasound
    Pelvic mass palpated Symptoms suggest endometrial polyps Drug therapy failed

    4. Endometrial biopsy (pipelle)


    Aged > 45 years Irregular or intermenstrual bleeding Drug therapy failed

    5. Thyroid function test


    Only performed when the history is suggestive of a thyroid disease

    Pipelle endometrial sampler

    Management

    When selecting appropriate management for the patient, it is important to consider and discuss: The patients preference of treatment risk/benefits of each option Contraceptive requirements: Family complete? Current contraception? Past medical history: Any contraindication to medical therapies Suitability for an anesthetic

    Medical treatment
    1. Mefenamic acid and NSAIDS (500mg p.o tds) Advantages: effective anegesia 1st line treatment when dysmenorrhea coexist Disadvantages: contraindicated for duodenal ulcer or severe asthma 2. Tranexamic acid (1g p.o qds) 3. Combined oral contraceptive pill (COCP) Advantages: doubles up as a very effective when taken properly Disadvantages: contraindicated for thromboembolism, ages > 35 who smokes, breast cancer, grossly overweight

    4. Norethisterone (5-10mg tds on day 6-26) 5. Levonogastrel intrauterine system (LNG-IUS) 6. GnRH agonist: Gasorelin 3.6mg monthly subcutaneous implant Decapeptyl 3mg monthly s/c or im Buserelin 300g nasal spray tds 7. Danazol

    LNG-IUS/mirena

    Surgical management
    1. Endometrial ablation 2. Hysteroscopic resection polyp / fibroid 3. Hysterectomy

    Endometrial ablation

    Endometrial ablation

    Fibroid resection

    Complications
    Excessive or prolonged menstrual bleeding can lead to other medical conditions, including: Severe pain Infertility Toxic shock syndrome Anemia

    Thank you

    Anda mungkin juga menyukai