fibroids ranging from microscopic to huge
location of leiomyomas
submucosal, subserosol, intramural or interstitial, pedunculated, cervical
s/s of leiomyomas
pelvic pressure, hypomenorrhea, metrorrhagia, dysmenorrhea, abdominal enlargement, irregularly shaped, firm, large uterus
scant periods or spotting
uterine bleeding at irregular times
severely painful periods
differential diagnosis of leiomyomas
pregnancy, ovarian neoplasm, endometriosis, tubal ovarian abscess
diagnosis of leiomyomas
examination, ultrasound, CT/MRI
management of leiomyomas
myomectomy, androgens, GnRH agonists, hysterectomy
Complications of leiomyomas
premature labor, spontaneous abortions, infertility, heavy bleeding, difficult delivery, increased postpartum bleeding, impedes ability to perform exam
absence of menses
failure to menstruate by age 16
absence of menses for 6 months after normal menstruation
causes of amenorrhea
genetic disorders, endocrine disorders, anatomic abnormalities, medications, marked weight loss, strenuous exercise, cervical scarring, hpo axis disorder
assessment of amenorrhea
pregnancy test, thyroid hormone, FSH, estrogen & progesterone, prolactin level, complete review of systems
the 5-10 year period of gradual decrease in ovarian hormone production prior to menopause
the period of time including the climacteric up to menopause
permanent cessation of menses
cessation of menses for one year
changes of menopause
decreased estrogen & progesterone, unpredictable menses, heavier & longer cycles, fatigue, mood changes, disruption in sleep, vasomotor instability, bleeding and spotting in between cycles, FSH & LH increase
treatments for menopause
decrease caffeine, dress in layers, soy products, ginsing, SSRIs
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