pediatrician in panchkula - paras bliss

8/15/2019 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 ……..

pediatrician in panchkula - paras bliss

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