Menstrual Issues

stock-photo-one-woman-stomach-pain-cramp-743142In this webinar recording, Dr Emma Boulton discusses a general approach to common menstrual disorders encountered in every day practice.

Emma highlights the importance of taking a good, comprehensive history, while considering the “reproductive stage” of the patient in front of you. We briefly consider the approach to various menstrual issues, including irregular cycles and dysmenorrhoea. Indications for investigations and referral is also discussed.

Important points in the discussion to remember:

To evaluate menstrual disorders:

  • Take a thorough history
  • Perform a focused examination
    • Abdominal examination
    • Pelvic examination
  • Consider appropriate Investigations
    • PAP Smear +- chlamydia screening
    • Bloods depending on clinical picture
    • Pelvic ultrasound
  • Examples and causes of menstrual difficulties:
    • Dysfunctional Uterine Bleeding
    • Anovulatory cycles (teenagers and Peri-menopausal women)
    • PCOS (poly cystic ovarian syndrome)
    • Infections (chlamydia)
    • Cervical pathology
    • Malignancies
    • Complications of Pregnancy
    • Uterine Fibroids
    • Endometriosis
    • Iatrogenic
    • Emotional Stress

You will find lots of great gynae and obs content on the blog Bits and Bumps: there’s always plenty to learn from Penny Wilson and Marlene Pearce

Further reading and recommended resources:

RANZCOG Guidelines:

Jean Hailes Website

The Royal Women’s Hospital Clinical Guidelines

RCH Clinical Guidelines: Adolescent Gynaecology: Menorrhagia

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