puberty and hormones notes taken by iris lau from the 2014 australian & nz dravet syndrome...
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Puberty and Hormones
Notes taken by Iris Lau from the 2014 Australian & NZ Dravet Syndrome Family Conference
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Puberty and Hormones
Adolescence is a developmental stage involving
• Cognitive
• Pubertal
• Separation
• Independence
• Peer group
• Risk taking
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Puberty Blues – the challenge's of managing periods
Menstrual management – for women with intellectual and/or severe physical disability
AIMS
Optimise quality of life
Ensure no pain, no negative health consequences
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Puberty Blues- understanding hormones
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Puberty blues – the challenges
Menstrual management – for women with intellectual and/or severe physical disability
Optionssimple measure – reduce pain, reduce heaviness of periods
“the pill” – continuously – “skipping periods”
Depo Provera – need to watch bones
Mirena IUS
iris Note: the speaker explained that “skipping periods” –
Like grandmothers – have ten kids, normally only 55 periods in their life
Like pregnancy – no period, then go to breast feeding with no period.
So no period for few years is not unhealthy, just the way to control the hormones
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Continuous Pill
“skipping periods on the pill”
Concern by some regarding “ not natural”
Well….How many periods in a life time is natural?
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Continuous Pill continued
Tricks to make it work
…need higher dose with most anticonvulsants
Need continuous dose ( not changing dose pill)
Care with lamotrigine – as may reduce the effectiveness of this
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Non Contraceptive benefits of the pill
50-80% reduction in ovarian cancer
50% reduction in endometrial cancer
Reduction in bowel cancer
Less endometriosis
Less Anaemia
Less ovarian cysts
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Rules for skipping
Period at the end of the first packet
Can go continuous after that
Go as long as possible…until spotting starts, put up with this for 2 or 3 days
If persists, have a 4 days off the pill and restart
If cyclic 4 week bleed or pain despite continuous pill not suppressed. Need to increase pill dose
Can’t always achieve no periods at all – accepts 4-6 month interval
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Mirena IUS 95% less bleeding by 6 months
97% less bleeding by 12 months
Lasts 5+ years
95% satisfaction reported by families of young women with disabilities at RCH
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Implanon
Lasts 3 years
Almost 100% effective in preventing pregnancy
Causes irregular bleeding – resulting in removal in 25-30% of young women
Not helpful if aiming for constant hormones