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s/s of leiomyomas
pelvic pressure, hypomenorrhea, metrorrhagia, dysmenorrhea, abdominal enlargement, irregularly shaped, firm, large uterus
differential diagnosis of leiomyomas
pregnancy, ovarian neoplasm, endometriosis, tubal ovarian abscess
Complications of leiomyomas
premature labor, spontaneous abortions, infertility, heavy bleeding, difficult delivery, increased postpartum bleeding, impedes ability to perform exam
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
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
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