1 / 17

Managing Abnormal Menses: Understanding Causes and Evaluations in Uterine Bleeding

This comprehensive session led by Caroline Hewitt, RNC, MSN, NP, explores abnormal uterine bleeding (AUB), clarifying key terminology and identifying potential causes. Participants will learn to evaluate AUB through a detailed history, physical exam, and appropriate laboratory tests. The session discusses various diagnoses like menorrhagia, oligomenorrhea, and amenorrhea, alongside management strategies. By reviewing specific examples, such as a case study of a 16-year-old with amenorrhea, attendees will gain practical insights into assessment and treatment options for patients experiencing abnormal menstrual patterns.

amos-duran
Télécharger la présentation

Managing Abnormal Menses: Understanding Causes and Evaluations in Uterine Bleeding

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Managing Abnormal Menses Caroline Hewitt, RNC, MSN, NP Director Clinical Education Cicatelli Associates

  2. Objectives • Clarify terminology related to abnormal uterine bleeding (AUB) • Identify possible causes of (AUB) • Discuss evaluation plan for AUB • Review management for specific diagnosis

  3. Terminology • Dysfunctional uterine bleeding • Menorrhagia • Oligomenorrhea • Polymennorhea • Metrorrhagia/menorragia • Intermenstrual bleeding • Premenstrual spotting • Post coital spotting

  4. What is normal?

  5. What is abnormal? • Not bleeding • Amenorrhea • Primary vs secondary • Bleeding unpredictably • AUB

  6. Where is the bleeding?

  7. Why is it bleeding? • Pregnancy • Anatomic anomaly • Fibroid, polyp, adenomyosis • Endocrine • Malignancy • Infection • Bleeding disorders • Drugs

  8. Stages of life

  9. History • Significance of good history taking! • Cyclic versus non-cyclic bleeding • Characterization of bleeding and amount • Associated moliminal symptoms • Medications • Sexual history

  10. Amenorrhea • Secondary • No menses for more than three cycles or six months • Rule out pregnancy • Other causes: • Ovarian disease • Hypothalamic dysfunction • Pituitary • Uterine disease • other

  11. Ovarian Dysfunction • Polycystic ovarian syndrome • Associated characteristics • Hair growth, truncal obesity, diabetes • Sonographic findings • Free testosterone / DHEAS ?

  12. Endocrine Disorder • Thyroid dysfunction • Hyperprolactinemia • Hyperandrogenemia

  13. Evaluation • BMI • Tanner stage • S&S Virilization • Vulvar/vaginal/cervical lesions • Uterine/adnexal tenderness • Cultures/labs

  14. Cultures/Labs • Urine pregnancy test • Pap (if indicated) • GC/Chl • Endo bx (if indicated) • Transvaginal ultrasonography (if indicated) • Bloods for systemic/endocrine disease

  15. Gertie • 16 year old high school student presents complaining that, “ I have not had a period for 5 months”. • She is 5’2’’ and 132 lbs •  PMH/PSH,  meds

  16. Gertie • What further information would you like to have? • Initial differential? • How would you approach your PE? • What labs/tests would you perform? • Using your presumptive dx, what plan would you make for Gertie?

  17. Conclusion • Summary • Questions • Comments • Thank you! • chewitt@cicatelli.org

More Related