Gynecologic problems

one of the most common gynecologic problems occurring most often in women in their teens and early 20s

• NSAIDs
• Acetaminophen
• anti-prostaglandins
• Oral contraceptives
• Heat
• Acupuncture
• Relaxation
• Dietary changes

• a collection of symptoms that are cyclic in nature
• change in NT - serotonin
• changes in fluid shifts

• Nutrition - Ca and Mg supplements
• Drug therapy - hormone therapy, SSRIs
• CAM - chaseberry supplements

• endometrial tissue implantation outside the uterine cavity
• on ovaries, cul de sac of Douglas, scarring on surrounding tissue
• major cause of infertility and very painful
• unknown cause

• drug therapy - contraceptives to decrease stimulation to tissues
• NSAIDs
• androgenic agents
• CAM - heat packs, relaxation, massage, Ca, Mg, meditation
• surgery

bleeding that is excessive or abnormal in amount or frequency - endometrial overgrowth

• endocrine disturbances
• polycystic ovary disease
• stress
• obesity/underweight
• long-term drug use
• anatomic abnormalities

• hormone manipulation
• surgery
• - dilation and curettage procedure - uterus scraping
• - laser or balloon endometrial ablation - removal of built up uterine cells
• - mymectomy - removal of fibroids
• - hysterectomy

normal biologic event marked for most women by the end of menstrual periods - 12 months of no periods

• hot flashes
• night sweats
• dry vagina

• Hormone replacement therapy - lowest dose for shortest amount of time
• healthy lifestyle
• physically active
• Ca, vitamin D
• relaxation
• good nutrition

• changes in ovarian function
• can happen over several years - gradual

• vaginal discharge and itching
• inflammation of the lower genital tract resulting from a disturbance of the balance of hormones and flora in the vagina and vulva

• Itching
• change in vaginal discharge
• odor
• lesions

• antibiotics
• STIs
• lice/scabies

• S. aureus produces endotoxins that into bloodstream, causing extreme illness
• Don't leave your tampons in too long

abrupt onset of high temp, HA, sore throat, vomiting, diarrhea, generalized rash and hypotension

• Restoring fluid, electrolytes
• antibiotics
• change your tampons
• use a clean, new tampon each time

downward displacement of the uterus

• Elderly women
• Can also occur in women who just had a baby

• Dyspareunia
• Backache
• Pressure in the pelvis
• Bowel or bladder problems

• Passaries
• surgery - suspend uterus or hysterectomy

cystocele

rectocele

abnormal opening between two adjacent organs or structures

• Urethrovaginal
• Vesicovaginal
• Rectovaginal

• Traumatic child birth
• surgery
• radiation
• cancer

• Ovarian cyst
• uterine leiomymomas

a fibroid that causes heavy bleeding and risk usually increases with age

• NSAIDs
• radiological procedure that stops blood supply to the fibroid
• total hysterectomy
• laparascopic removal

pedunculated tumors on stalks arising from the mucosa and extending to the opening of the cervical os

a reproductive cancer of which adenocarcinomas are the most common type

• Main symptom is postmenopausal bleeding
• CA-125 tumor marker
• chest x-ray for metastasis

• Radiation therapy - intercavity brachytherapy or external
• drug therapy
• chemotherapy
• hormone therapy
• CAM

progression from totally normal cervical cells to premalignant changes in appearance of cervical cells to changes in function and ultimately to cancer

carcinoma in situ

• preinvasive is only in the cervix
• invasive is spread to other structures

• protection against the highest risk/most common HPV's responsible for most cancers
• 3 injections over 6 months

• often asymptomatic
• painless vaginal bleeding - classic symptom
• water, blood-tinged vaginal discharge that may become dark and foul smelling as disease progresses
• leg pain along psiatic nerve
• flank pain
• unexplained weight loss
• pelvic pain
• dysuria
• hematuria
• rectal bleeding
• chest pain
• cough

Pap smear

serous adenocarcinoma - most common

• often asymptomatic and not detected until end stages
• vague abdominal discomfort
• dyspepsia
• indigestion
• gas
• distention
• looks like gallbladder disorders
• ovarian antibody CA-125

cancer of the female external genitals - most are squamous cell

• irritation or itching in perianal area
• sore that won't heal

• Toluidine blue
• Keyes dermal punch

• Wound care
• Promote urinary and bowel elimination
• Managing pain
• Addressing sexuality

• Rare
• Treatment with common cancer treatments

• rarest of all gynecologic cancers
• most common symptoms - postmenopausal bleeding, increased abdominal pain, water vaginal discharge, leukorrhea
• treatment - total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy