DOCSLIB.ORG

Menstrual Disorder

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Menstrual Disorder Menstrual Disorder N.SmidtN.Smidt--AfekAfek MD MHPE Lake Placid January 2011 The Menstrual Cycle two phases: follicular and luteal Normal Menstruation Regular menstruation 28+/28+/--7days;7days; Flow 4 --7d. 40ml loss Menstrual Disorders Abnormal Beleding –– Menorrhagia ,Metrorrhagia, Polymenorrhagia, Oligomenorrhea, Amenorrhea -- Dysmenorrhea –– Primary Dysmenorrhea, secondary Dysmenorrhea Pre Menstrual Tension –– PMD, PMDD Abnormal Uterine Beleeding Abnormal Bleeding Patterns Menorrhagia --bleedingbleeding more than 80ml or lasting >7days Metrorrhagia --bleedingbleeding between periods Polymenorrhagia -- menses less than 21d apart Oligomenorrhea --mensesmenses greater than 35 dasy apart. (in majority is anovulatory) Amenorrhea --NoNo menses for at least 6months Dysfunctional Uterine Bleeding Clinical term referring to abnormal bleeding that is not caused by identifiable gynecological pathology "Anovulatory Uterine Bleeding“ is usually the cause Diagnosis of exclusion Anovulatory Bleeding Most common at either end of reproductive life Chronic spotting Intermittent heavy bleeding Post Coital Bleeding Cervical ectropion ( most common in pregnancy) Cervicitis Vaginal or cervical malignancy Polyp Common Causes by age Neonatal Premenarchal ––EstrogenEstrogen withdrawal ––ForeignForeign body ––Trauma,Trauma, including sexual abuse Infection ––UrethralUrethral prolapse ––Sarcoma botryoides ––Ovarian tumor ––PrecociousPrecocious puberty Common Causes by age Early postmenarche Anovulation (hypothalamic immaturity) Bleeding diathesis Stress (psychogenic, exercise induced) Pregnancy Menarche years Pregnancy OCs, Trauma Infection Perimenopause Decline in ovarian function during menopause Superimposed pathology (polyps, neoplasia etc) abnormal uterine bleeding in the premenopausal women Anovulatory UB Bleeding PregnancyPregnancy--relatedrelated problems Thrombocytopenia von Willebrand's disease Infection Leukemia Cervicitis Endocrine disorders Endometritis Ovarian problems Trauma Cyst Malignant Tumors Tumor Cervical Endometriosis Endometrial Systemic disease Ovarian Diabetes mellitus Benign pathology Renal disease Cervical polyp Systemic lupus Endometrial polyp erythematosus Leiomyoma Medications Adenomyosis Hormonal,Anticoagulants, platelet inhibitors Androgens, spironolactone History History Can help to distinguish between the 4 common causes: –– Pregnancy ––AbnormalAbnormal endocrine control ––GynecologicGynecologic pathology ––SystemicSystemic disease History Patient’s age Onset of Menarche Prior menstrual history Contraceptive and sexual history Symptoms of systemic disease. Menstrual record chart Physical Examination Physical Examination Growth parameters Thorax/breasts –– Short stature –– Shield chest, –– Obesity (BMI > 30 –– widely spaced nipples kg/m2) –– Galactorrhea –– Underweight (BMI Abdomen <18.5)Arm span >height –– Abdominal/pelvic mass plus 5 cm Tanner staging Skin and hair –– Low for both breast and –– Acanthosis nigricans pubic hair –– Abnormal bleeding –– High for both breast and (bruises, petechiae) pubic hair –– Striae –– Divergent –– Hyperpigmentation, External genitalia vitiligo –– Imperforate hymen –– Low hair line –– Clitoromegaly –– Hirsutism, acne, malemale-- pattern balding –– Perineal trauma Neck –– Vaginal discharge, –– Thyroid enlargement –– genital ulcer, –– Webbed neck –– condyloma lata Imperforated Hymen Check yourself Short stature Turner syndrome, hypothalamichypothalamic--pituitarypituitary disease Obesity (BMI > 30 kg/m2) Polycystic ovary syndrome (PCOS) Underweight (BMI <18.5) Hypothalamic amenorrhea secondary to eating disorder, exercise, or weight loss from systemic disease Arm span >height plus 5 cm Delayed epiphyseal closure secondary to hypogonadism Check yourself Acanthosis nigricans PCOS, insulin resistance Abnormal bleeding (bruises, petechiae) Bleeding diathesis Striae Cushing syndrome Hyperpigmentation, vitiligo Adrenal insufficiency Low hair line Turner syndrome Hirsutism, acne, malemale--patternpattern balding Hyperandrogenism (PCOS, CAH, androgenandrogen--secretingsecreting tumor, Check yourself presence of Y chromosome) Thyroid enlargement Hypothyroidism, hyperthyroidism Webbed neck Turner syndrome Shield chest, widely spaced nipples Turner syndrome Galactorrhea Hyperprolactinemia Abdominal/pelvic mass Ovarian tumor, hematocolpos Check yourself Tanner staging Low for both breast and pubic hairDelayed sexual development (ie, constitutional delay of puberty) High for both breast and pubic hairNormal progression of puberty Check yourself External genitalia Imperforate hymenImperforate hymen ClitoromegalyHyperandrogenism (PCOS, CAH, androgen --secreting tumor, presence of Y chromosome) Perineal traumaSexual abuse Vaginal discharge, genital ulcer, condyloma lata Sexually transmitted infection Initial Approach to Abnormal Uterine Bleeding in Premenopausal Patients (K.Oriel, S.Schrager AFP , 1999) Initial Approach to Abnormal Uterine Bleeding in Perimenopause patients Menorrhagia Bleeding disorder systemic illness endocrine disorders structural lesions Anovulatory Metrorrhagia Exogenous hormones Infections Polyps, Ectropion Foreign bodies abuse Management --MenorrhagiaMenorrhagia I.I. Medical treatment Hormonal: COC, Progesterone ( Norethindrone acetate (5 to 10 mg), or Micronized progesterone (200 mg) A.A. NSAIDs B.B. Hemostatic medications ( Aminocaproic acid )) C.C. Progesteron Releasing IUD D.D. Gonadotrophin releasing hormone agonist Management --MenorrhagiaMenorrhagia Surgical Treatment D&C Endometrial ablation Hysterectomy Amenorrhea Primary ––MenarcheMenarche 14.5 age of 95 thth percentile in US ––CongenotalCongenotal and anatomical defects Secondary ––PregnancyPregnancy ––PCOPCO ––HormonalHormonal causes ––AcquiredAcquired ablation or scarring of endometrium Approach to Oligomenorrhea in Adolescents Uptodate 2010 Other Menstrual related “disorders” Dysmenorrhea ––PrimaryPrimary –– Secondary Premenstrual physical symptoms premenstrual syndrome (PMS), Premenstrual dysphoric disorder (PMDD), Primary Dysmenorrhea More common in adolescence (decreases with age) Only in ovulatory periods Some risk factors PathogenesisPathogenesis--“Uterine“Uterine angina” Symptoms : lower abd pain, N&V, HA, fatigue, malaise. Tx: NSAIDs Major causes of secondary dysmenorrhea Nongynecologic Gynecologic disorders disorders Endometriosis Inflammatory bowel Adenomyosis disease Ovarian cysts Irritable bowel Pelvic adhesions syndrome Pelvic inflammatory disease Uteropelvic junction Uterine polyps obstruction Congenital obstructive Psychogenic disorders müllerian malformations Cervical stenosis ExaminationExamination--SecondarySecondary Dysmenorrhea Tenderness, thickness, nodularity at uteroutero--sacralsacral ligament,enlarged uterus Lateral displacement of cervix Cervical stenosis Adnexal enlargement from an endometrioma Endometriosis clue: red hair color; scoliosis; and dysplastic nevi TreatmentTreatment--SecondarySecondary Dysmenorrhea Treat the underlying cause NSAID’s Hormonal contraceptives PrePre--sacralsacral neurectomy in selected cases Surgery for specific pathology PMS & PMDD Symptoms of PMS Behavioral Psychological Physical Mood lability (81) ) )91Irritability 91(iibltriratI ( y ) 92)Fatigue 92(tiag ( Fue Food cravings (78) ) 92)Fatigue 92(tiag ( Fue ) 90)Bloating 90(tlgoBi ( an Increased Anxiety/tension Breast appetite (70) ) 89) 89( ( ) 85)tenderness ssenr85(ednte ( Oversensitivity Depression80 ( 80)) Acne71 ( )) 71 (69) Forgetfulness ) 67)Swelling 67(llgeiS ( nw Anger (67) ) 56) 56( ( ) 60)Headache 6 0(echadaeH ( Crying easily (65) Poor GI symptoms Feeling isolated concentration ) 48) 48( ( ) 47) 47( ( (65) ) 8)1Hot 81flashes (sehsflaotH ( Heart ) 4)1palpitations 41(i lttpsiaaonp ( 41Dizziness 41( sDsizezin ( )) Definitions of PMS & PMDD PMS -- Recurrent psychological or physical symptoms during the luteal phase of menstrual cycle, resolves by the end of menstruation, and interferes with some aspect of function. Premenstrual Dysphoric Disorder (PMDD) --moremore severe form of PMS meeting DSMDSM--IVIV criteria .. Premenstrual Disorders Etiology Cause is unknown! Interactions of ovarian hormones with neurotransmitters ––AlterationsAlterations of serotoninergic and GABAnergic activity in the brain. Imbalance between Estrogen and Progesterone levels Serotonin deficiency Effects of hormone shift on endogenous opiods Biologic, physiologic, environmental and social factors all seems to be contributory Genetic factors seems to play a role. PMDD DSMDSM--VV criteria: ––>> 5 symptoms of PMS 1 week prior to and resolve during menses ––>>11 psychological symptom x 1 year during most cycles Depressed mood, increased sensitivity, anxiety, irritability ––InterferesInterferes with social, occupation, sexual or schooschooll functioning ––SymptomsSymptoms discretely related to menstrual cycle and not a worsening of a psychiatric or medication condition –– Documented symptoms meeting criteria for at least 3 cycles Occur in luteal phase Resolves near the start of menstruation Creates problems or impairment Not better explained by another diagnosis Johnson SR. Obstet Gynecol. 2004; Rapkin AJ. Am J Manag Care . 2005; ACOG. ACOG Practice Bulletin No. 15. 2000; Dickerson LM et al. Am Fam Physician. 2003. Treatment approach General advice about diet, exercise & stress reduction should be considered before starting specific treatment Women with marked underlying psychopatology
Load more

Recommended publications
  • Evaluation of the Uterine Causes of Female Infertility by Ultrasound: A
    Evaluation of the Uterine Causes of Female Infertility by Ultrasound: A Literature Review Shohreh Irani (PhD)1, 2, Firoozeh Ahmadi (MD)3, Maryam Javam (BSc)1* 1 BSc of Midwifery, Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Iranian Academic Center for Education, Culture, and Research, Tehran, Iran 2 Assistant Professor, Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, Iranian Academic Center for Education, Culture, and Research, Tehran, Iran 3 Graduated, Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Iranian Academic Center for Education, Culture, and Research, Tehran, Iran A R T I C L E I N F O A B S T R A C T Article type: Background & aim: Various uterine disorders lead to infertility in women of Review article reproductive ages. This study was performed to describe the common uterine causes of infertility and sonographic evaluation of these causes for midwives. Article History: Methods: This literature review was conducted on the manuscripts published at such Received: 07-Nov-2015 databases as Elsevier, PubMed, Google Scholar, and SID as well as the original text books Accepted: 31-Jan-2017 between 1985 and 2015. The search was performed using the following keywords: infertility, uterus, ultrasound scan, transvaginal sonography, endometrial polyp, fibroma, Key words: leiomyoma, endometrial hyperplasia, intrauterine adhesion, Asherman’s syndrome, uterine Female infertility synechiae, adenomyosis, congenital uterine anomalies, and congenital uterine Menstrual cycle malformations. Ultrasound Results: A total of approximately 180 publications were retrieved from the Uterus respective databases out of which 44 articles were more related to our topic and studied as suitable references.
    [Show full text]
  • Heavy Menstrual Bleeding Among Women Aged 18–50 Years Living In
    Ding et al. BMC Women's Health (2019) 19:27 https://doi.org/10.1186/s12905-019-0726-1 RESEARCHARTICLE Open Access Heavy menstrual bleeding among women aged 18–50 years living in Beijing, China: prevalence, risk factors, and impact on daily life Chengyi Ding1†, Jing Wang2†, Yu Cao3, Yuting Pan3, Xueqin Lu3, Weiwei Wang4, Lin Zhuo3, Qinjie Tian5 and Siyan Zhan3* Abstract Background: Heavy menstrual bleeding (HMB) has been shown to have a profound negative impact on women’s quality of life and lead to increases in health care costs; however, data on HMB among Chinese population is still rather limited. The present study therefore aimed to determine the current prevalence and risk factors of subjectively experienced HMB in a community sample of Chinese reproductive-age women, and to evaluate its effect on daily life. Methods: We conducted a questionnaire survey in 2356 women aged 18–50 years living in Beijing, China, from October 2014–July 2015. A multivariate logistic regression model was used to identify risk factors for HMB. Results: Overall, 429 women experienced HMB, giving a prevalence of 18.2%. Risk factors associated with HMB included uterine fibroids (adjusted odds ratio [OR] =2.12, 95% confidence interval [CI] = 1.42–3.16, P <0.001)and multiple abortions (≥3) (adjusted OR = 3.44, 95% CI = 1.82–6.49, P < 0.001). Moreover, women in the younger age groups (≤24 and 25–29 years) showed higher risks for HMB, and those who drink regularly were more likely to report heavy periods compared with never drinkers (adjusted OR = 2.78, 95% CI = 1.20–6.46, P = 0.017).
    [Show full text]
  • Cervical Polypectomy
    Cervical Polypectomy Author: Consultant Department: Gynaecology/ Colposcopy Document Number: STHK1225 Version: 4 Review date: 01/10/2022 What is a polyp? Your doctor/nurse has advised you to have a polypectomy, which is the removal of a polyp. A polyp is a flesh-like structure (often described as looking like a cherry on a stalk or a skin tag), which can develop in many places in the body, including the cervix and uterus. It may have blood vessels running through it, which can often be the cause of bleeding. If it is thought the polyp is in your uterus, you will need to have a hysteroscopy (a procedure that uses a narrow camera to look inside the cavity of the uterus). This procedure is carried out as a gynaecology outpatient appointment at the Women’s Centre, and is performed in a special clinic in the Diagnostic Suite. You will receive a further appointment for this treatment and be given a different leaflet to explain the hysteroscopy procedure. If for any reason the polyp cannot be removed or fully removed during either of these treatments, the doctor will advise you of other options. Reasons for the procedure As you know you have been referred to the Colposcopy Clinic because you have a polyp on the cervix. Sometimes the cervical polyp is broad based, where it does not have a stalk but sits on the cervix. Often they cause no symptoms and are found as a result of other examinations. Polyps are usually benign (non-cancerous). Less than 1 % (1 in 100) may have pre-cancerous or cancerous changes within them; it is therefore advisable to have them removed.
    [Show full text]
  • MR Imaging Evaluation of Obstructing Vaginal
    The Egyptian Journal of Radiology and Nuclear Medicine xxx (2017) xxx–xxx Contents lists available at ScienceDirect The Egyptian Journal of Radiology and Nuclear Medicine journal homepage: www.sciencedirect.com/locate/ejrnm Original Article MR imaging evaluation of obstructing vaginal malformations with hematocolpos or hematometra in adolescent girls: A cross sectional study ⇑ Deb Kumar Boruah a, , Rajanikant R. Yadav b, Kangkana Mahanta a, Antony Augustine a, Manoj Gogoi c, Lithingo Lotha d a Department of Radio-diagnosis, Assam Medical College and Hospital, Dibrugarh, Assam, India b Department of Radio-diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India c Department of Pediatric Surgery, Assam Medical College and Hospital, Dibrugarh, Assam, India d Department of Obstetrics & Gynecology, Assam Medical College and Hospital, Dibrugarh, Assam, India article info abstract Article history: Objective: Vaginal or uterine outlet obstruction leads to hematocolpos or hematometra. Detection of the Received 2 December 2016 etiology of this entity is important to guide adequate surgical management and thereby avoid complica- Accepted 29 April 2017 tions and to preserve fertility. The aim of this study was to evaluate obstructing vaginal malformations in Available online xxxx adolescent girls presenting with hematocolpos or hematometra with MR imaging. Materials and methods: A hospital based prospective study was conducted in a tertiary care centre from Keywords: September 2015 to October 2016. The study
    [Show full text]
  • Clinical Acute Abdominal Pain in Children
    Clinical Acute Abdominal Pain in Children Urgent message: This article will guide you through the differential diagnosis, management and disposition of pediatric patients present- ing with acute abdominal pain. KAYLEENE E. PAGÁN CORREA, MD, FAAP Introduction y tummy hurts.” That is a simple statement that shows a common complaint from children who seek “M 1 care in an urgent care or emergency department. But the diagnosis in such patients can be challenging for a clinician because of the diverse etiologies. Acute abdominal pain is commonly caused by self-limiting con- ditions but also may herald serious medical or surgical emergencies, such as appendicitis. Making a timely diag- nosis is important to reduce the rate of complications but it can be challenging, particularly in infants and young children. Excellent history-taking skills accompanied by a careful, thorough physical exam are key to making the diagnosis or at least making a reasonable conclusion about a patient’s care.2 This article discusses the differential diagnosis for acute abdominal pain in children and offers guidance for initial evaluation and management of pediatric patients presenting with this complaint. © Getty Images Contrary to visceral pain, somatoparietal pain is well Pathophysiology localized, intense (sharp), and associated with one side Abdominal pain localization is confounded by the or the other because the nerves associated are numerous, nature of the pain receptors involved and may be clas- myelinated and transmit to a specific dorsal root ganglia. sified as visceral, somatoparietal, or referred pain. Vis- Somatoparietal pain receptors are principally located in ceral pain is not well localized because the afferent the parietal peritoneum, muscle and skin and usually nerves have fewer endings in the gut, are not myeli- respond to stretching, tearing or inflammation.
    [Show full text]
  • Evaluation of Abnormal Uterine Bleeding
    Evaluation of Abnormal Uterine Bleeding Christine M. Corbin, MD Northwest Gynecology Associates, LLC April 26, 2011 Outline l Review of normal menstrual cycle physiology l Review of normal uterine anatomy l Pathophysiology l Evaluation/Work-up l Treatment Options - Tried and true-not so new - Technology era options Menstrual cycle l Menstruation l Proliferative phase -- Follicular phase l Ovulation l Secretory phase -- Luteal phase l Menstruation....again! Menstruation l Eumenorrhea- normal, predictable menstruation - Typically 2-7 days in length - Approximately 35 ml (range 10-80 ml WNL - Gradually increasing estrogen in early follicular phase slows flow - Remember...first day of bleeding = first day of “cycle” Proliferative Phase/Follicular Phase l Gradual increase of estrogen from developing follicle l Uterine lining “proliferates” in response l Increasing levels of FSH from anterior pituitary l Follicles stimulated and compete for dominance l “Dominant follicle” reaches maturity l Estradiol increased due to follicle formation l Estradiol initially suppresses production of LH Proliferative Phase/Follicular Phase l Length of follicular phase varies from woman to woman l Often shorter in perimenopausal women which leads to shorter intervals between periods l Increasing estrogen causes alteration in cervical mucus l Mature follicle is approximately 2 cm on ultrasound measurement just prior to ovulation Ovulation l Increasing estradiol surpasses threshold and stimulates release of LH from anterior pituitary l Two different receptors for
    [Show full text]
  • The Impact of Menstrual Disorder Towards Female University Students
    Athens Journal of Health & Medical Sciences - Volume 8, Issue 2, June 2021 – Pages 119-134 The Impact of Menstrual Disorder Towards Female University Students By Azlan Ahmad Kamal*, Zarizi Ab Rahman± & Heldora Thomas‡ The purpose of this study is to study whether the menstrual disorder have impact on quality of life among female students which focus on physical and health education students from semester 1 until semester 8 in Uitm Puncak Alam, Selangor. The study was conducted to clarify the types of menstrual disorder among female students. The study also was aimed to identify the symptoms of menstrual disorder experience among female students before and during their menstruation and to determine the effect of menstrual disorder among female students towards their quality of life. Data from 74 respondents were used for the statistical analysis. The data were collected by using non purposive sampling. Questionnaires were used to obtain data for this study and the data for this study were analysed by using Microsoft Excel Software. Results showed that, menstrual disorder give impacts towards female quality of life. Future research should emphasize on other scope of study and more research about menstrual disorder may help organization to increase their performance and knowledge about female and their menstruation. Keywords: menstrual disorder, female students and effects, quality of life Introduction The history reported contains a wide range of reproductive and menstrual myths in women. In ancient times, menstruating women are generally thought to have an evil spirit. Aristotle, which is the Greek philosopher, Plato student, he said that "menstrual women could dull a mirror with a glance, and that they would be enchanted by the next person to peer into it" (Fritz and Speroff 2011).
    [Show full text]
  • Left Vaginal Obstruction and Complex Left Uterine Horn Communication in a 12 Year Old Female Barry E
    Perlman et al. Obstet Gynecol cases Rev 2015, 2:7 ISSN: 2377-9004 Obstetrics and Gynaecology Cases - Reviews Case Report: Open Access Left Vaginal Obstruction and Complex Left Uterine Horn Communication in a 12 Year Old Female Barry E. Perlman*, Amy S. Dhesi and Gerson Weiss Department of Obstetrics, Gynecology and Women’s Health, Rutgers - New Jersey Medical School, Newark, USA *Corresponding author: Barry E. Perlman DO, Department of Obstetrics, Gynecology and Women’s Health, Rutgers - New Jersey Medical School, MSB E-506, 185 South Orange Avenue, Newark, NJ 07101-1709, USA, Tel: 732 233 0997, E-mail: [email protected] Transabdominal pelvic sonogram revealed two prominent uterine Abstract cornua with an endometrial thickness of 3 mm in each horn. The Obstructive Müllerian duct anomalies are an infrequently right cornu measured 11.4 x 2.0 x 3.6 cm and the left cornu measured encountered clinical problem. The use of imaging and surgical 10.4 x 2.8 x 4.1 cm. A 7 cm mass in the endocervical canal, concerning exploration allowed for diagnosis and treatment of symptoms of a for hematocolpos, represented an occlusion extending to the left complex obstructive müllerian anomaly. We present a case of a 12 vagina (Figure 1). year old female with a history of intermittent lower abdominal pain and absent left kidney who was found to have an obstructed left She underwent further imaging with two MRI studies that were vagina and complex left uterine horn communications resulting in mutually inconclusive and inconsistent in regards to her pelvic hematocolpos, hematometra, and endometriosis.
    [Show full text]
  • ICD-9-CM and ICD-10-CM Codes for Gynecology and Obstetrics
    Diagnostic Services ICD-9-CM and ICD-10-CM Codes for Gynecology and Obstetrics ICD-9 ICD-10 ICD-9 ICD-10 Diagnoses Diagnoses Code Code Code Code Menstral Abnormalities 622.12 Moderate Dysplasia Of Cervix (CIN II) N87.2 625.3 Dysmenorrhea N94.6 Menopause 625.4 Premenstrual Syndrome N94.3 627.1 Postmenopausal Bleeding N95.0 626.0 Amenorrhea N91.2 627.2 Menopausal Symptoms N95.1 626.1 Oligomenorrhea N91.5 627.3 Senile Atrophic Vaginitis N95.2 626.2 Menorrhagia N92.0 627.4 Postsurgical Menopause N95.8 626.4 Irregular Menses N92.6 627.8 Perimenopausal Bleeding N95.8 626.6 Metrorrhagia N92.1 Abnormal Pap Smear Results 626.8 Dysfunctional Uterine Bleeding N93.8 795.00 Abnormal Pap Smear Result, Cervix R87.619 Disorders Of Genital Area 795.01 ASC-US, Cervix R87.610 614.9 Pelvic Inflammatory Disease (PID) N73.9 795.02 ASC-H, Cervix R87.611 616.1 Vaginitis, Unspecified N76.0 795.03 LGSIL, Cervix R87.612 616.2 Bartholin’s Cyst N75.0 795.04 HGSIL, Cervix R87.613 Cervical High-Risk HPV DNA 616.4 Vulvar Abscess N76.4 795.05 R87.810 Test Positive 616.5 Ulcer Of Vulva N76.6 Unsatisfactory Cervical 795.08 R87.615 616.89 Vaginal Ulcer N76.5 Cytology Sample 623.1 Leukoplakia Of Vagina N89.4 795.10 Abnormal Pap Smear Result, Vagina R87.628 Vaginal High-Risk HPV DNA 623.5 Vaginal Discharge N89.8 795.15 R87.811 Test Positive 623.8 Vaginal Bleeding N93.9 Disorders Of Uterus And Ovary 623.8 Vaginal Cyst N89.8 218.9 Uterine Fibroid/Leiomyoma D25.9 Noninflammatory Disorder 623.9 N89.9 Of Vagina 256.39 Ovarian Failure E28.39 624.8 Vulvar Lesion N90.89 256.9 Ovarian
    [Show full text]
  • Menstrual Disorders Among Nursing Students at Al Neelain University
    Sudan Journal of Medical Sciences Volume 15, Issue no. 2, DOI 10.18502/sjms.v15i2.7067 Production and Hosting by Knowledge E Research Article Menstrual Disorders Among Nursing Students at Al Neelain University, Khartoum State Aisha Mohammed Adam1, Hammad Ali Fadlalmola2, and Huda Khalafala Mosaad3 1Department of Obstetrics and Gynecological Nursing, Faculty of Nursing Sciences, Al Neelain University, Sudan 2Department of Community Health Nursing, Nursing College, Taibah University, Saudi Arabia 3Faculty of Applied Medical Sciences, Department Nursing, Hafar Albatin University, Saudi Arabia Abstract Background: Menstrual disorders can severely affect the daily life of young females, particularly the student population, which generates a massive tension that extends to families, but they seldom affect the quality and standard of life. Corresponding Author: Objectives: The aim of this study was to determine the morbidity nature of menstrual Dr. Hammad Ali Fadlelmola; disorders among nursing students and their effect on students’ life activities. Nursing College, Taibah Methods: This study was a descriptive cross-sectional institutional-based study University, Saudi Arabia conducted at the Al Neelain University, Faculty of Nursing. Of the 200 students email: [email protected] recruited, 149 completed the questionnaire with the responding rate of (74.5%). Data were collected using a self-administered structured questionnaire. Received 12 March 2020 Results: Of the 149 participants, most were young and in the age range of 18–24 years Accepted 7 June 2020 with a mean age of 21 years. Most students (74%) started their menarche at a normal age Published 30 June 2020 range of 12–15 years. A relatively high dysmenorrhea (94.0 %) was observed among Production and Hosting by the participants.
    [Show full text]
  • Having a Cervical Polypectomy
    Gynaecology information Having a cervical polypectomy Introduction This leaflet gives you advice and information about having a cervical polypectomy (removal of polyps from the neck of the womb). Please read it before you go home so that you can have your questions answered before you leave. Feel free to discuss any questions or concerns with your nurse or telephone the Colposcopy Clinic on 0118 322 7197 or Sonning Ward on: 0118 322 7181. What is a cervical polypectomy and why do I need one? A cervical polyp is a small piece of tissue, usually on a stalk, that grows on the cervix (neck of the womb). Sometimes the cervical polyp is broad-based, where it does not have a stalk but sits on the cervix. Often they cause no symptoms and are found as a result of other examinations. Polyps are usually benign (non-cancerous). Less than 1% may have pre- cancerous or cancerous changes within them; it is therefore advisable to have them removed. A polypectomy is the removal of polyps. What are the risks of a cervical polypectomy? The procedure is very low risk, but may cause an infection or heavier bleeding. Before being sent for a polypectomy your doctor will have carried out a full pelvic examination, including an examination of your cervix using a speculum and you may have had an ultrasound or scan. What happens during a cervical polypectomy? This is normally done in the outpatient clinic. You will be asked to undress from the waist down and lie down on an examination couch. A speculum (the instrument used to open up the vagina) is passed into the vagina to expose the cervix.
    [Show full text]
  • Primary Dysmenorrhea in Relation to Oxidative Stress and Antioxidant Status: a Systematic Review of Case-Control Studies
    antioxidants Review Primary Dysmenorrhea in Relation to Oxidative Stress and Antioxidant Status: A Systematic Review of Case-Control Studies Maria Karolina Szmidt * , Dominika Granda, Ewa Sicinska and Joanna Kaluza Institute of Human Nutrition Sciences, Warsaw University of Life Sciences–SGGW, 159C Nowoursynowska Str., 02-776 Warsaw, Poland; [email protected] (D.G.); [email protected] (E.S.); [email protected] (J.K.) * Correspondence: [email protected]; Tel.: +48-22-593-7119 Received: 27 August 2020; Accepted: 13 October 2020; Published: 15 October 2020 Abstract: Primary dysmenorrhea is defined as painful menstrual cramps of uterine origin in the absence of pelvic pathology and is the most common gynecological disorder among women of reproductive age. The aim of this study was to systematically review case-control studies that have investigated the oxidative stress, antioxidant status, and inflammation markers among women with primary dysmenorrhea and controls. The study protocol was registered with PROSPERO (no. CRD42020183104). By searching PubMed and Scopus databases as well as reference lists, six case-control studies with fifteen eligible markers (seven oxidative stress, seven antioxidant status, one inflammation) were included in this review. The quality of the included studies was assessed as medium or high. The systematic review included 175 women with primary dysmenorrhea and 161 controls. The results indicate an elevated level of oxidative stress, especially of lipid peroxidation among dysmenorrheal women. For the antioxidant status, limited evidence was found for a lower status among primary dysmenorrhea women, and only one study examined one inflammation marker (hs-CRP), which makes it impossible for such a conclusion.
    [Show full text]