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Disorders of menstruation - Coggle Diagram
Disorders of menstruation
Dysfunctional uterine bleeding
Defination
It is defined as an irregular, painless bleeding of endometrial origin that may be excessive, prolonged or without pattern.
It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining.
Physiology
During an anovulatory cycle, the corpus luteum does not form.
Progesterone secretion is prolonged resulting in irregular shedding of the endometrium.
Causes
Pelvic inflammatory diseases
Uterine fibroids
Intrauterine contraception device.
Hormonal imbalance.
Diagnostic tests
Pregnancy test, coagulation profile, serum progesterone level, and serum prolactin level.
Management
Oral contraceptives such as oralcon can be used to balance hormones.
Dilation and curettage procedure.
Hysterectomy
Endometrial ablation
Dysmenorrheoa
Defination
It is a painful menstruation with no identifiable pelvic pathology characterised by crampy pain that begins before or shortly after the onset of menstrual flow.
Clinical manifestations
Cramping in the lower abdomen.
Low back pain
Nausea and vomiting
Pain radiating down the legs.
Fatigue.
Physiology
Excessive production of prostaglandins, result in the development of the myomentrial hyperactivity which cause painful contractions of the uterus.
Diagnostic tests
A pelvic examination to exclude possible disorders such as endometriosis, adenomyosis and uterine fibroid.
A laparoscopy to identify organic causes.
Management
Prostaglandins antagonist such as NSAIDs.
Advise the patient to rest and apply heat to the lower abdomen and do some exercises to release discomfort.