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Changes before the change: Perimenopausal Bleeding PowerPoint Presentation

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Description : Check out this medical presentation on cancer titled "Changes before the change: Perimenopausal Bleeding" to know about abnormal uterine bleeding (AUB).

Tags : Cancer, Perimenopausal Bleeding, abnormal uterine bleeding, AUB, Anovulatory AUB, Benign, Hormonal Changes,

Published on : May 05, 2021 | Views : 1443 | Downloads : 2

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Changes before the change: Perimenopausal Bleeding World Menopause Day 2017
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IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017 Abnormal Uterine Bleeding (AUB) - Definition Bleeding that is unlike normal menstrual flow in terms of frequency, duration and quantity. It includes infrequent or frequent bleeding, heavy menstrual bleeding or intermenstrual bleeding AUB is a leading cause for gynecological consultations in the peri- and post-menopausal age groups.
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AUB subsets in the Perimenopause Ovulatory AUB Ovulatory bleeding may be heavy and can be associated with typical premenstrual symptoms and painful periods. IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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World Menopause Day 2017 Anovulatory AUB Anovulatory bleeding, which is found more frequently during the perimenopause compared to the premenopause, is often linked to prolonged periods, heavier flow and an irregular cycle. If prolonged (e.g. in PCOS or associated with obesity), anovulatory bleeding has a stronger link to endometrial cancer and endometrial hyperplasia IMS theme Series: Perimenopausal Bleeding AUB subsets in the Perimenopause
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Abnormal Uterine Bleeding - Etiology 1. Hormonal Changes 2. Benign Anatomic Changes Uterine Polyps Uterine Fibroids Adenomyosis Low Thyroid Function Other medical conditions, i.e. coagulopathy 3. Cancer Primarily endometrial, but also cervical. IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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The goal of diagnosis is to distinguish women with anatomic causes from women with normal anatomy. Identifying endometrial malignancy, although uncommon among the AUB etiologies, is often the main purpose of the investigations. Abnormal Uterine Bleeding - Diagnosis IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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FIGO Nomenclature: PALM-COEIN Adapted from Practice Bulletin No. 128. ACOG Obstet Gynecol 2012;120:197–206 IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Before AUB HMB DUB Menorrhagia Menometrorrhagia Oligomenorrhe Now AUB-P AUB-A AUB-L AUB-M AUB-C AUB-O AUB-E AUB-I AUB-N IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Assessment of abnormal uterine bleeding General assessment History and bleeding pattern Physical, pelvic and speculum examination Laboratory tests including: Full blood count, iron studies, (thyroid, hCG – if indicated) Disorders of hemostasis (if indicated) Evaluate pelvic organs and endometrium ultrasound scan Hysteroscopy MRI (if indicated) IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Imaging Techniques The primary imaging test for the evaluation of abnormal uterine bleeding is transvaginal ultrasound. This maybe more difficult in cases of co-existing myomas, previous surgery, marked obesity, axial uterus or adenomyosis. In such cases SIS - saline infusion sono-hysterography can be helpful. Hysteroscopy as a diagnostic tool may also be employed if intra-uterine pathology is suspected. It can be done in an outpatients setting using small telescopes and usually requires no analgesia. An inpatient procedure will be required in 15-20% IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Endometrial Sampling Endometrial sampling is required to diagnose endometrial abnormality. This can be done, usually after an ultrasound or hysteroscopy, with a vacuum aspiration system, e.g. Pipelle. However, this will only sample a small proportion of the cavity and there is a high incidence of false negative results, and cancer may be missed. AUB will often require further evaluation. IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Treatment of abnormal uterine bleeding Treatment goals for patients with AUB include regulation of menstrual cycles, minimization of blood loss and improvement in quality of life. Treatment options include pharmacological approaches (either hormonal or non-hormonal), and surgical or radiological procedures. Awareness, reassurance and keeping a healthy lifestyle will contribute to the treatment options for AUB. IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Management of abnormal uterine bleeding (1) Non-hormonal medical treatments Non-steroidal anti-inflammatory drugs Anti-fibrinolytic agents (ie, tranexamic acid) Iron supplements, in case of anemia Hormonal medical treatments Cyclical or long-acting progestogens Combined oral contraceptives GnRH analogs (fibroid-associated) Selective progesterone receptor modulators (fibroid-associated) Levonorgestrel intrauterine system (LNG-IUS) IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017
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Endometrial ablation Uterine artery embolization (fibroid-associated) Hysterectomy IMS theme Series: Perimenopausal Bleeding World Menopause Day 2017 Management of abnormal uterine bleeding (2)