pediatrician in panchkula - paras bliss
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Gynecological issues in womenMenstrual problems
Dr Harpreet Kour IsherConsultant Obstetrics & Gyanecology
Paras Bliss, Panchula
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Onset o! "rst perio#swhat is normal ?
• $irst menstrual perio#s calle# menarche%
• 'erage age o! menarche is () years
• *sually occur within )+ years o! breast
bu##ing which is the "rst sign o! puberty• Cycles may be irregular in the "rst two
years ranging !rom e'ery )( #ays to -.
#ays%• By the thir# year /0+102 o! girls ha'e a
)(+- #ay cycles as in a#ults%
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What is abnormal ?
• 3hen menstrual perio#s ha'e not begunwithin years o! breast #e'elopment
• 3hen the perio# between perio#s e4cee#s
months• 3hen perio#s ha'e not begun by (. years
• 3hen perio#s begin be!ore 1 years
•
3hen perio#s ha'e not begun by (- yearsan# there are signs e4cessi'e coarse hairgrowth or an eating #isor#er
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• 3hen perio#s last !or more than 5 #ays
• 6e7uire !re7uent pa# change i%e% e'ery (+) hours
• ssociate# with hea'y blee#ing an# a!amily history o! blee#ing #isor#er or easybruising or e4cessi'e blee#ing%
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Menstrual problems inrepro#ucti'e age
What is normal ?
• Cycle length o! )(+. #ays
• Perio# not more than 5 #ays
• 8ess than one pa# soae# in two hours9usually not more than / pa#s or tamponsin a #ay
•
Pain in tummy , thighs an# lower bacusually on "rst two #ays an# !ew hoursbe!ore onset o! perio#s
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What is abnormal ?
• Blee#ing more than 5 #ays or hea'yblee#ing e%g% changing a pa# 'ery ) hours!re7uently%
• Blee#ing at less than )(+)) #ays inter'al%• Blee#ing at more than -+. #ays inter'al%
• 6ecurrent post coital blee#ing: a!ter se4ual
intercourse ;• Intermenstrual blee#ing: in between
cycles ;
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6easons+Hea'y or prolonge#
blee#ing
• 8esions within the ca'ity or wall o! thewomb :uterus ;
• =hicene# lining o! the ca'ity o! the uterus
• Hormonal imbalance an# ano'ulation• Cancers
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Other causes o! abnormal blee#ing
• *n#iagnose# pregnancy
• Pel'ic in!ections
• >n#ometriosis
• $unctional o'arian cysts
• Birth control pills an# in?ections
• Intra uterine #e'ice lie copper =
• $amilial blee#ing #isor#ers• >n#ocrine #isor#res esp% thyroi# an#
polycystic o'arian syn#rome
•
8i'er or renal #iseases
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=ests@@
• Clinical e4amination inclu#ing an internale4amination
• Pap smear
• Pregnancy test• *ltrasoun#
• Hormonal pro"le
•Clotting tests
• >n#ometrial biopsy
• Diagnostic Hysteroscopy
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roun# menopause@
• Irregular cycles
• Blee#ing may be less !re7uent
• Blee#ing may be more !re7uent
• Blee#ing may #ecrease in amount
• Blee#ing may increase in amount
Important to consult if bleeding heavy
and /or frequent ;and if periods continuetill 52 years of age
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!ter menopause
• Menopause A o perio#s !or at least oneyear continuously
• ny blee#ing a!ter menopause, always
consult a gynecologist%• Blee#ing a!ter menopause always
abnormal
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=ests
• =rans 'aginal ultrasoun#
• Diagnostic Hysteroscopy
• >n#ometrial biopsy
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3ith the #oc@%
3ill assess you on the whole an# consi#er
• 6is !actors as obesity , polycystico'aries , in!ertility or ne'er ha#
pregnancies, hypertension , #iabetes%• Contracepti'e history an# irregularities
•
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THANK YOU ……..