-
PMS and PMDD tx
- dec caffeine, etoh, cigarettes, chocolate
- SSRI
-
Causes of menorrhagia
- Endometrial hyperplasia
- Uterine fibroids
- Dysfunctional uterine bleeding
- Intrauterine device
-
Causes of hypomenorrhea
- obstruction, stenosis
- OCPs
-
Metrorrhagia
- Intermenstrual bleeding
- Caused by polyps, cancer, exogenous estrogen
-
Menometrorrhagia
- Irregular time, duration, or amount
- Caused by polyps, ca, exogenous estrogen, malignant tumors
-
Oligomenorrhea
- >35d cycles
- pregnancy, menopause, anorexia, tumor secreting estrogen
-
postcoital bleeing causes
- cervical ca
- cervical polyps
- atrophic vaginitis
-
Dysfunctional uterine bleeding
- unexplained abnormal bleeding
- bx if >35yo to rule out carcinoma
- exclude hypothyroid and hyperprolactinoma
-
Most common cause of labial fusion
21B hydroxylase deficiency
-
Vulvar epithelial abnormalities
- Lichen sclerosis: white and thin, give topical steroids
- Squamous cell hyperplasia/hyperkeratosis: raised white, give sitz baths and lubricants
- Lichen planus: In 30-70yom violet flat papules, give topical steroids
-
Bartholin gland cyst
- lateral
- Pain
- I&D, cx, marsupialization
-
Risk factors for vaginitis
- Abx (normal pH is <4.5)
- DM
- Overgrowth of flora
-
Bacterial vaginosis bug, tx
- Gardenerella
- Metro or clina
-
Tx for candidiasis
Miconazole, clotrimazole, econazole, or nystatin
-
Paget disease of vulva
- Red lesion with white coating
- Bx
- Tx is Vulvectomy
-
Staging of vulvar SSC
- 0: in situ
- 1: <2 cm into wall
- 2: Volva or perineum >2cm
- 3: Lower urethra, anus, unilateral LN
- 4: bladder, rectim, b/l LN
- 4a: distant mets
-
Adenomyosis symptoms, dx
- Dysmenorrhea, menorrhagia
- Clinical, accurate is MRI, definitive is hysterectomy
-
Danazol
- androgen derivative
- used for endometriosis
- sides of acne, weight gain, hirsutism
-
Leuprolide
- GnRH agonist
- suppressess estrogen if continuous
- sides of hot flashes and dec bone density
-
PCOS hormones
- LH:FSH >3:1
- Due to high androgens
-
PCOS tx
- weight loss
- OCPs
- If want to be pregnant - clomiphene and metformin
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