Remember:
-The most common cause of secondary amenorrhea (pathological) is hypothalamic dysfunction.
-Most common cause of cryptomenorrhea is imperforate hymen.
-More common causes of primary amenorrhea are gonadal failure, abnormal chromosomal pattern, developmental defect of genital tract and disturbed function of the hypothalamo-pituitary-ovarian axis.
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-The most common cause of secondary amenorrhea (pathological) is hypothalamic dysfunction.
-Most common cause of cryptomenorrhea is imperforate hymen.
-More common causes of primary amenorrhea are gonadal failure, abnormal chromosomal pattern, developmental defect of genital tract and disturbed function of the hypothalamo-pituitary-ovarian axis.
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Definition of PCOS:
-Polycystic ovarian syndrome was originally described in 1935 by Stein and Leventhal as a syndrome manifested by amenorrhea, hirsutism, and obesity associated with enlarged polycystic ovaries due to increased androgens.It is the most common endocrine disorder in a woman of reproductive age.
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-Polycystic ovarian syndrome was originally described in 1935 by Stein and Leventhal as a syndrome manifested by amenorrhea, hirsutism, and obesity associated with enlarged polycystic ovaries due to increased androgens.It is the most common endocrine disorder in a woman of reproductive age.
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-Menorrhagia is defined as cyclic bleeding at normal intervals; the bleeding is either excessive in amount (> 80 mL) or duration (>7 days) or both.
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-Polymenorrhea is defined as cyclic bleeding where the cycle is reduced to an arbitrary limit of less than 21 days and remains constant at that frequency.
-If the frequent cycle is associated with excessive and/or prolonged bleeding, it is called epimenorrhagia.
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-If the frequent cycle is associated with excessive and/or prolonged bleeding, it is called epimenorrhagia.
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-Metrorrhagia is defined as irregular, acyclic bleeding from the uterus. Amount of bleeding is variable. While metrorrhagia strictly concerns uterine bleeding but in clinical practice, the bleeding from any part of the genital tract is included under the heading.
-Then again, irregular bleeding in the form of contact bleeding or intermenstrual bleeding in an otherwise normal cycle is also included in metrorrhagia. In fact, it is mostly related to surface lesion in the uterus.
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-Then again, irregular bleeding in the form of contact bleeding or intermenstrual bleeding in an otherwise normal cycle is also included in metrorrhagia. In fact, it is mostly related to surface lesion in the uterus.
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-Menometrorrhagia is the term applied when the bleeding is so irregular and excessive that the menses (periods) cannot be identified at all.
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•Causes of acyclic bleeding.
-DUB usually during adolescence, following childbirth and abortion and preceding menopause.
-Submucous fibroid
-Uterine polyp
-Carcinoma cervix and
-Endometrial carcinoma.
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-DUB usually during adolescence, following childbirth and abortion and preceding menopause.
-Submucous fibroid
-Uterine polyp
-Carcinoma cervix and
-Endometrial carcinoma.
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Causes of intermenstrual bleeding:
Apart from the causes of contact bleeding, other causes are:
-Urethral caruncle
-Ovular bleeding
-Breakthrough bleeding in pill use
-IUCD in utero
-Decubitus ulcer
-Progesterone only contraceptive use.
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Apart from the causes of contact bleeding, other causes are:
-Urethral caruncle
-Ovular bleeding
-Breakthrough bleeding in pill use
-IUCD in utero
-Decubitus ulcer
-Progesterone only contraceptive use.
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Causes of contact bleeding:
-Carcinoma cervix
-Mucus polyp of cervix
-Vascular ectopy of the cervix especially during pregnancy, pill use
-Infections as chlamydial or tubercular cervicitis
-Cervical endometriosis.
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-Carcinoma cervix
-Mucus polyp of cervix
-Vascular ectopy of the cervix especially during pregnancy, pill use
-Infections as chlamydial or tubercular cervicitis
-Cervical endometriosis.
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-Oligomenorrhea is the menstrual bleeding occurring more than 35 days apart and which remains constant at that frequency.
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-Hypomenorrhea is when the menstrual bleeding is unduly scanty and lasts for less than 2 days.
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-Heavy menstrual bleeding (HMB) is defined as a bleeding that interferes with woman's physical, emotional, social and maternal quality of life.
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-Dysfunctional uterine bleeding (DUB) is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic, and iatrogenic cause (pelvic pathology, e.g. tumor, inflammation or pregnancy is excluded).
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-The diagnosis of DUB is based with the exclusion of ‘organic lesion ’.
-Currently DUB is defined as a state of abnormal uterine bleeding following anovulation due to dysfunction of hypothalamo-pituitary-ovarian axis (endocrine origin).
-DUB, so defined, is not currently favored as the newer terminology, PALM-COIEN is more consistent and systematic.
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-Currently DUB is defined as a state of abnormal uterine bleeding following anovulation due to dysfunction of hypothalamo-pituitary-ovarian axis (endocrine origin).
-DUB, so defined, is not currently favored as the newer terminology, PALM-COIEN is more consistent and systematic.
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-DUB is a state of abnormal uterine bleeding. the types of DUB are:
A) anovulatory (90%):
(a) Menorrhagia,
(b) Metropathia hemorrhagica;
B) ovulatory (20%):
(a) Polymenorrhea;
(b) Oligomenorrhea;
(c) Functional menorrhagia (irregular shedding and irregular ripening of endometrium).
-Ovulatory type of DUB is usually characterized by:
(a) regular cycle length,
(b) heavy bleeding,
(c) there may be presence of PMS, dysmenorrhea, mastalgia and the biphasic pattern of BBT.
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A) anovulatory (90%):
(a) Menorrhagia,
(b) Metropathia hemorrhagica;
B) ovulatory (20%):
(a) Polymenorrhea;
(b) Oligomenorrhea;
(c) Functional menorrhagia (irregular shedding and irregular ripening of endometrium).
-Ovulatory type of DUB is usually characterized by:
(a) regular cycle length,
(b) heavy bleeding,
(c) there may be presence of PMS, dysmenorrhea, mastalgia and the biphasic pattern of BBT.
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Infertility definition:
-It is defined as the inability to conceive within one or more years of regular unprotected coitus.
-Primary infertility denotes those patients who have never conceived.
-Secondary infertility indicates previous pregnancy but failure to conceive subsequently.
-Fecundability is defined as the probability of achieving a pregnancy within one menstrual cycle. In a healthy young couple, it is 20%.
-Fecundity is the probability of achieving a live birth within a single cycle.
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-It is defined as the inability to conceive within one or more years of regular unprotected coitus.
-Primary infertility denotes those patients who have never conceived.
-Secondary infertility indicates previous pregnancy but failure to conceive subsequently.
-Fecundability is defined as the probability of achieving a pregnancy within one menstrual cycle. In a healthy young couple, it is 20%.
-Fecundity is the probability of achieving a live birth within a single cycle.
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Remember:
-Conception is not possible during pregnancy as the pituitary gonadal axis is suppressed by human chorionic gonadotropin (hCG) and hence, no ovulation.
-During lactation, infertility is said to be relative.
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-Conception is not possible during pregnancy as the pituitary gonadal axis is suppressed by human chorionic gonadotropin (hCG) and hence, no ovulation.
-During lactation, infertility is said to be relative.
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Remember:
-Approximately 74 days are required to complete the process of spermatogenesis.
-Additional 12–20 days are needed for spermatozoa to travel the epididymis.
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-Approximately 74 days are required to complete the process of spermatogenesis.
-Additional 12–20 days are needed for spermatozoa to travel the epididymis.
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Postcoital test (PCT) (Sims-Huhner test):
-Principle: PCT is to assess the quality of cervical mucus and the ability of sperm to survive in it. PCT is rarely done these days.
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-Principle: PCT is to assess the quality of cervical mucus and the ability of sperm to survive in it. PCT is rarely done these days.
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-Adenomyosis is a condition where there is ingrowth of the endometrium, both the glandular and stromal components, directly into the myometrium.
-It may be diffuse or focal. It is also defined as endometriosis interna.
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-It may be diffuse or focal. It is also defined as endometriosis interna.
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Remember:
-Preterm prelabor rupture of membranes is rupture of membranes before 37 weeks and before the onset of labor.
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-Preterm prelabor rupture of membranes is rupture of membranes before 37 weeks and before the onset of labor.
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