UNIT IV Presented by Hezil Reema Barboza HYPOMENORRHEA

UNIT IV Presented by Hezil Reema Barboza

HYPOMENORRHEA • Scanty period and spotting at periods , is extremely light menstrual blood flow. • Causes: genetic, hormonal, stress, • Treatment: reassurance, no specific treatment, treatment according to the cause

OLIGOMENORRHEA • Frequent or very light menstruation • Causes: polycystic ovary syndrome, stress, eating disorder, intense physical exercise, chronic illness, obesity, endocrine disorders, tubercular endometriosis • Symptoms: periods occuring at intervals of more than 35 days, irregular periods unpredictable flow, difficulty with conceiving

Treatment • Oral Medications - Oral medications can help balance the level of hormones in the body. Once these hormone levels are balanced, the menstrual cycle will return back to normal. • Reducing Environmental Stress • Alternative treatments such as natural hormone replacement, acupuncture , dietary changes, and nutrition counseling are recommended.

Metrorrhagia • Vaginal bleeding among premenopusal women • Irregular, acyclic bleeding from uterus

Causes • Hormonal imbalances • Fibroids, Polyps • Inflammation or infection of the uterus, cervix or vagina • After menopause, dry vaginal walls • Endometriosis • Cancer • Sexually transmitted infections • Use of intrauterine device • Miscarriage • Implantation bleeding • Ectopic pregnancy

Symptoms • Light to heavy bleeding between regular menstrual periods • Abdominal pain or cramps • In cases of miscarriage and ectopic pregnancy, severe abdominal cramps

Treatment • A tampon may be used to make sure bleeding is indeed from the vagina. • For heavy bleeding, take plenty of rest. • Do not take aspirin as it may extend vaginal bleeding. • Hormonal treatments may be necessary for hormonal imbalances. • For cases of bacterial infection, antibiotics are essential. • In some cases, a hysteroscopy or hysterectomy may be required.

Nursing management of patient • Assessment • History collection • Nutritional assessment • Complete physical examination 1. Nutritional imbalnce related to nausea and vomiting 2. Discomfort , pain related to uterine muscle contraction

1. Activity intolerance related to fatige 2. Ineffective coping mechanism related to effects of menstruation 3. Anxiety related to effects of menstruation 4. Knowledge deficit related to cause and management of menstruation

Evaluation • What is Metrorrhagia? • What is the nursing management of patients with menstrual disorder ?

References • Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Text book of medical surgical nursing. 11 th ed. New Delhi: Wolters Kluwer Pvt Ltd; 2009. • Lewis, Dirkson, Heitkemper, Bucher. Lewis's Medical Surgical Nursing. India: Elsevier; 2011.