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Painful menstrual flow
Most common in young women
Painful uterine cramping; lower abdomen and back pain
Tx: NSAIDS, oral contraceptives, heat packs, relaxation techniques, low-fat food choices

Premenstrual Syndrome

Caused by changes in the level of serotonin and fluid shifts
Physical and emotional symptoms
Occurs in women age 20-40
Symptoms include: depression, angry outbursts, anxiety, headache, bloating, unclear
Tx: counseling, exercise, change in eating habits, antidepressants (SSRI)


Uterine tissue implantation outside the uterine cavity (on an ovary)
Monthly menstruation/bleeding occurs out of place causing scars; possibly infertility
Affects women of all ages
Symptoms include:pain(prior to mentruation), pelvic tenderness, painful sexual
TX: like dysmenorrhea, endostatins, removal of adhesions

Dysfunctional Uterine Bleeding

excessive bleeding
Due to hormonal imbalance - no ovulation occurs → increase progesterone →
uterus overgrowth occurs →shedding of uterine lining (heavy bleeding)
TX: hormone manipulation, NSAIDS, D&C, endometrial ablation


Normal cessation of menstrual periods
Amenorrhea for 12 months
Ovaries no longer produce estrogen
S/S: hot flashes, vaginitis, menstrual irregularity
TX: HRT (oral, transdermal, intravaginal), exercise, calcium supplements

Toxic Shock Syndrome (TSS)

Exotoxins produced from bacteria cross the vaginal mucosa and enter bloodstream
Related to use of tampons
S/S: quick onset of fever, hypotension, sunburn-like rash in eyes/skin
TX: remove infection source, fluid balance restoration, IV antibiotics, pressors

Uterine Prolapse

Downward displacement of uterus
Decrease of pelvic support
Occur in stages
S/S: painful intercourse, backache, pressure on pelvis
TX: pelvic support to elevate uterus (pessaries/spheres), estrogen therapy, surgery

Total vaginal hysterectomy (TVH)

Presence of small fibroids on uterus
Removal of uterus & cervix through vagina

Total abdominal hysterectomy (TAH)

Present of large leimyomas
Removal of uterus & cervix via bikini incision

Surgery - POST-OP

Incision/site, bleeding, dressing assessment
Assess pain, vital signs, labs (esp. H&H,) fluid intake
Cough & deep breathing, incentive spirometry, early ambulation
Emotional supports, community resources

Endometrial Cancer

- inner uterine lining
Most common; slow growth; bleeding leads to early detection
S/s: postmenopausal bleeding

Cervical Cancer

squamous/columnar cells transform to cancerous cells (transformation zone)
Caused by HPV exposure to cells on outside of cervix
S/s: May present as warts

Ovarian Cancer

- tumors growing on ovary surface
Rapid growing, spread quickly
Metastasize to distant sites via blood/lymph circ.
May be linked to excessive estrogen exposure
Leading cause of death of reproductive cancers
S/s: abdominal pain, GI disturbances
Low survival rate - diagnosed in later stages

Cancer Treatments

Vary amongst cancers
Surgical procedures
Palliative care


Pap smears, abnormal bleeding, discharge,
Abdominal/back pain, gas, incontinence, external appearance
Family support
Knowledge of cancer and overall health
Pelvic exam: speculum, lubricant
Inspected for color, shape, dilation, herpes, discharge, nodules, masses, bleeding

Nursing Diagnosis

Anxiety and Fear
Acute Pain
Anticipatory Grieving Risk for Sexual Dysfunction
Ineffective Coping
Potential for Hemorrhage

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