Heavy and Irregular Periods

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

177

Pages:

4
Author:

Mariam A. A.

Heavy and Irregular Periods History Can you describe what you mean by heavy bleeding? How much would you say there is? When you say irregular, how have you gotten it so far? Is there any associated pain? Is there flooding? Have you stained your clothes? Are there any clots? When did the irregularity start happening? Have you had anything like this before? Can you think of anything that might have caused it? Does anything make it better or worse? Associated features? Is there any abnormal vaginal discharge? Is there a fever? Is there any weight changes? Is there any changes to appetite? Do you have any night sweats or flushing? Do you have any vaginal dryness? Are there any changes to your urinary or bowel habits? Do you feel more tired? Are you more pale ? Do you have new acne? Do you have any hair loss or hair growth at parts of your body that don’t usually have hair or have little hair? Is there any milk or discharge from your breast? Is there breast tenderness? Menstrual cycle history Age of menarche Physical Examination Findings Vitals BMI, thyroid and breast exam Abdominal exam Pelvic exam and bimanual exam Speculum exam Investigations Bloods: beta hCG, FBE, coagulation studies, LFTs, EUCs, TFTs, prolactin, testosterone, DHEAS, estrogen, LH, FSH , iron studies TVUS and a pelvic U/S MRI with or without ultrasound Hysterosalpingography D and C Histopathology Management Contraceptives Type depending on other risk factors and patient wishes Perform MEC criteria to assess If cardiovascular, VTE, smoker or other similar risk factors -> better to give progesterone methods such as mirina or copper IUD Also mention side effects The cause of hyperplasia may be due to perimenopause phase as there is still some sort of ovulation so estrogen present for hyperproliferation -> but since menstrual cycle is irregular -> progesterone not sufficient to cause endometrial shedding. Give vit D and calcium Lifestyle management Weight loss Diet Avoiding smoking, alcohol and drugs