Key concepts

Q Unrecognized pregnancy remains the most common cause of amenorrhea, and a urine pregnancy test should be one of the first steps in the evaluation of this disorder.

For most conditions associated with primary and secondary amenorrhea, estrogen treatment (along with a progestin to minimize the risk of endometrial hyperplasia) is utilized.

Causes of menorrhagia can be divided into systemic disorders and specific uterine abnormalities.

Ö1 Intrauterine pregnancy, ectopic pregnancy, and miscarriage must be at the top of the differential diagnosis list for any woman presenting with heavy menses.

The reduction in menorrhagia-related blood loss with the use of nonsteroidal antiinflammatory drugs (NSAIDs) and oral contraceptives (OCs) is directly proportional to the amount of pretreatment blood loss.

The most significant mechanism for primary dysmenorrhea is the release of prostanoids and possible eicosanoids in the menstrual fluid; given their impact on inhibiting prostaglandins as well as their ability to provide direct analgesia, NSAIDs are the treatment of choice.

Intrauterine devices (IUDs) are considered therapeutic options in a variety of menstrual-related disorders. Guidelines from the American College of Obstetricians and Gynecologists (ACOG) indicate that any woman (regardless of parity) at low risk of sexually transmitted diseases is a good candidate for IUD use.

Anovulatory bleeding, also referred to as dysfunctional uterine bleeding, is secondary to the effects of unopposed estrogen and does not include bleeding owing to an anatomic lesion of the uterus.

© The use of metformin and thiazolidinediones for anovulatory bleeding associated with polycystic ovary syndrome (PCOS) is beneficial for anovulatory bleeding and fertility and also improves glucose tolerance and decreases overall cardiovascular risk.

Problems related to the menstrual cycle are common in women of reproductive age. The issues considered in this chapter are the most frequently encountered menstrual-related difficulties and include amenorrhea, menorrhagia, dysmenorrhea, and dysfunctional uterine bleeding. The need for effective treatments for these disorders stems from their impact on any or all of the following: A reduced quality of life, negative effects on reproductive health, and the potential for long-term detrimental health effects, such as osteoporosis in the case of amenorrhea and cardiovascular disease in the case of polycystic ovary disease.

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook

Post a comment