Menstrual dysfunction

Part 1 of ebook "Frontiers in gynecological endocrinology (Volume 1: From symptoms to therapies)" provide readers with content about: menstrual dysfunction in young women; metabolism, hyperandrogenism, body weight and reproduction; ovarian stimulation, surgery and insufficiency;... Please refer to the part 1 of ebook for details!

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Estrogen (ES-truh-jin): A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions. Fallopian tube (fuh-LOH-pee-in): A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.

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Menstrual dysfunction can signal an underlying abnormality that may have longterm health consequences. Although frequent or prolonged bleeding usually prompts a woman to seek medical attention, infrequent or absent bleeding may seem less troubling, and the patient may not bring it to the attention of the physician. Thus, a focused menstrual history is a critical part of every female patient encounter. Pelvic pain is a common complaint that may relate to an abnormality of the reproductive organs but may also be of gastrointestinal, urinary tract, or musculoskeletal origin.

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Definition and Criteria ≥ 6 months of pain Incomplete relief by medical measures Altered activities due to pain (e.g., missed work, homebound, depression, sexual dysfunction) Etiologies Leiomyoma Endometriosis Adhesions, adenomyosis Pelvic inflammatory disease (PID) Infections other than PID Neoplasia Workup 1. Detailed history (focusing on above etiologies): Temporal pattern Radiation Associated symptoms Past surgeries Last menstrual period (LMP) 2. Physical exam: Look for: Masses Cervical motion tenderness Gastrointestinal (GI) complaints Neurological testing 3.

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Polycystic Ovarian Syndrome: Treatment The major abnormality in patients with PCOS is the failure of regular, predictable ovulation. Thus, these patients are at risk for the development of dysfunctional bleeding and endometrial hyperplasia associated with unopposed estrogen exposure. Endometrial protection can be achieved with the use of oral contraceptives or progestins (medroxyprogesterone acetate, 5–10 mg, or prometrium, 200 mg daily for 10–14 days of each month).

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Harrison's Internal Medicine Chapter 51. Menstrual Disorders and Pelvic Pain Menstrual Disorders and Pelvic Pain: Introduction Menstrual dysfunction can signal an underlying abnormality that may have long-term health consequences. Although frequent or prolonged bleeding usually prompts a woman to seek medical attention, infrequent or absent bleeding may seem less troubling, and the patient may not bring it to the attention of the physician. Thus, a focused menstrual history is a critical part of every female patient encounter.

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Algorithm for evaluation of amenorrhea. β-hCG, human chorionic gonadotropin; PRL, prolactin; FSH, follicle-stimulating hormone; TSH, thyroidstimulating hormone. Hypogonadotropic Hypogonadism Low estrogen levels in combination with normal or low levels of LH and FSH are seen with anatomic, genetic, or functional abnormalities that interfere with hypothalamic GnRH secretion or normal pituitary responsiveness to GnRH. Although relatively uncommon, tumors and infiltrative diseases should be considered in the differential diagnosis of hypogonadotropic hypogonadism (Chap. 333).

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Physiology of the Female Sexual Response The female sexual response requires the presence of estrogens. A role for androgens is also likely but less well-established. In the CNS, estrogens and androgens work synergistically to enhance sexual arousal and response. A number of studies report enhanced libido in women during preovulatory phases of the menstrual cycle, suggesting that hormones involved in the ovulatory surge (e.g., estrogens) increase desire. Sexual motivation is heavily influenced by context, including the environment and partner factors.

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