SECONDARY DYSMENORRHEA

• typically occurs after 25 years of age
• caused by pelvic pathology
• full lower abdominal pain radiates to the back or thighs
• pain may occur before the menstrual period and last throughout the days of menstrual flow

which nursing interventions would hep relieve symptoms of dysmenorrhea?

• pelvic rock exercises
• effleurage
• low fat diet
• prostaglandin inhibitors

primary infertility

inability to conceive a child after at least 1 year of a active, unprotected sexual relations without contraceptive

secondary infertility

inability to conceive after having once conceived or to maintain a pregnancy long enough to deliver a viable infant

factors contributing to infertility in women

• problems with ovulation
• an abnormality in the pathway between the cervix and fallopian tube
• an abnormality in the endometrium of the uterus, or malformation of the uterus
• tumors in the reproductive tract

causes of repeated pregnancy loss

• an abnormality in fetal chromosomes that result in spontaneous abortion
• abnormalities of the cervix or uterus
• disorders of the endocrine or immune system
• infections

health risks of menopause

• osteoporosis
• Coronary heart disease
• treatment options during menopause

activities that increase the risk of osteoporosis

• inadequate lifetime intake of calicum and vitamin D
• smoking
• excess alcohol intake
• excess caffeine, cola, or soft drink intake

pelvic relaxation syndrome

lack of estrogen results in weakening of tissue structures causing pelvic relaxation

S/S of pelvic relaxation syndrome

• rectocele may result in constipation, soiling, or painful defecation
• uterine prolapse my result in dyspareunia:uterus may protrude from the vaginal orifice
• a sense of fullness in the pelvis and backache
• stress incontinence

disorder of the female reproductive system

polycystic ovarian syndrome

congenital condition in which many cysts develop on one or both ovaries and produce excess estrogen

disorder of the female reproductive system

dysfunctional uterine bleeding

• oligomenorrhea: decreased menstruation
• amenorrhea: absences of menstruation
• menorrhagia: excessive menstrual bleeding

disorders of female reproductive system

abnormal uterine bleeding

bleeding not related to the menstrual period

leiomyoma

aka - fibroids

• benign tumors of the uterine muscle
• medical management: nonsteroidal antiflammatory drugs or oral contraceptives, uterine artery embolization, myomexctomy, and hysterctomy

S/S of leiomyomas

may range from none to back aches, urinary frequency, abnormal uterine bleeding

Endometrisosis

disease in which tissue similar to the lining of the uterus grows outside the uterus

-leading to severe pain in the pelvis and possibly make it harder to get pregnant

inflammations of the lower genital tract

inflammation or infections of the vulva, vagina, or cervix most often occur when he acid enviorment of the vaginal secretions changes, enabling the survival of the pathogenic organisms

S/S of inflammation of the lower Genital tract

genital lesions, dysuria, and vaginal discharge and pruritus

treatment for inflammation of the lower genital tract

• local creams, vaginal suppositories, or systemic antimicrobials
• hand hygiene is important
• wearing loose cotton underwear
• psychological support

Toxic shock syndrome risk factors

the prolonged use of absorbency tampons, cervical caps, or diaphragms

symptoms of toxic shock syndrome

sudden spiking fever, flu like symptoms, hypotension, generalized rash resembling a sunburn, and peeling skin on the palms or soles

treatment for toxic shock syndrome

hospitalization and intensive care with supportive treatments and intravenous antimicrobials

cancer of the female reproductive tract

vulvar cancer

• rare and occurs most commonly in older women
• treatment includes surgical removal of the pathologic tissue

cancer of the female reproductive tract

cancer of the cervix

risk factors for cancer of the cervix include having had multiple sex partners, sexual intercourse with uncircumcised males, starting intercourse at a young age.

Cancer of the cervix treatment

cryosurgery, electrosurgical excision or surgical ionization of the cervix

cancer of the female re[productive system

cancer of the uterus

most common malignant tumor of the female productive tract

-treatment is a hysterectomy

cancer of the female reproductive tract

cancer of the ovary

majority of ovarian cancer is known as a "silent cancer" because signs and symptoms are often nonspecific or vague

benign disorders of the breast

fibroadenoma

firm, rubbery, mobile nodules of fibrous and glandular tissue that may not be tender on Palpation

benign disorders of the breast

fibrocystic breast changes (FBC"s)

palpable thickening of portions of the breast tissue associated with pain and tenderness

benign disorders of the breast

intraductal papiloma

development of small elevations in the epithelium of the ducts of the breasts under the areola

the patient reports finding multiple smooth, well-delineated cysts in her breasts that are tender during the presentrual phase. the nurse should provide which instructions?

• eliminate alcohol and caffeine
• reduce fat in the diet
• consult a physician immediately

breast cancer- etiology

related ti estrogen and progesterone

-BRCA1 and BRCA2 gene mutations

breast cancer S/S

• lump in the breast
• nipple discharge or change in the skin patterns such as "dimpled skin"

breast cancer treatment

• surgery
• radiation therapy
• surgical removal of tumor and or/breast
• chemotherapy

breast cancer prevention

a healthy lifestyle that includes exercise and a diet rich in antioxidants and phytoestrogens (fruits, veggies, wine and tea)

-mammography screening

-tamoxfin to prevent recurring breast cancer

lymphedema

swelling caused by a buildup of lymph fluid in the body between the skin and muscle

-lymph fluid is part of the lymph system, which plays a role in your body's ability to fight infection and disease

lymphedema

DO NOT'S

• do not assess blood pressure in the affected arm
• do not give injections or do venipuncture in the affected arm
• provide meticulous skin care

female reproductive system

primary external structures

• vuvla
• mons pubis
• labia majora
• labia minora
• clitoris
• urethral meatus
• vaginal vestibule
• perineum

phases of the female reproductive cycle during the childbearing years

ovarian cycle (follicular phase)

follicle-stimulating hormone (FSH) AND luteinizing hormone (LH) stimulate the maturation of the ova in preparation for fertilization

-estrogen peaks when the ovum is released

ovarian cycel

Luteal phase

• LH and progestrone are the primary hormones released in this phase.
• the blood supply to the uterus increases in preparation for possible implantation of a fertilized ovum
• if fertilization and implantation do not occur, the lining of the uterus will degrade and be shed during menstruation and the cycle begins again

sexual development In the fetus

• during the first weeks of pregnancy, the male nd female sexual organs are undifferentiated
• after the 7th week, rapid changes occur
• by the 12th week the external genitalia are formed and fully differentiated as male and female

sexual maturation

PUberty

• period of sexual maturation
• usually occurs between ages 9-17 years for girls; the average onset is 12 years of age.
• menses
• menarche
• menstruation

menopause

perimenopausal

• entering the phase known as the climacteric period
• menses become irregular in both pattern and flow and eventually stop altogether

normal menstruation

• a regular menstrual cycle is approximately every 28 days
• a healthy view of menarche as a natural physiologic process marking reproductive maturity should be encouraged

the menstrual cycle

• stage 1- menstrual cycle
• stage 2- days 6-14
• stage 3- ovulation
• stage 4- secretory stage

the nurse taking the gynecologic history of a postmenopausal Mexican American patient can help develop rapport by

• involving family members
• using a polite tone of voice
• respecting her privacy

normal vaginal discharge

contains cervical mucus, endometrial fluid, exudate

-bartholin glands and skene ducts, and products of normal flora

the normal breasts made of adipose tissue, milk-producing glands ducts and fibrous tissue that rest on the chest muscle.

(T/F)

true

female health screening and assessment

breast self-examination

• may be done monthly, about 1 week after menstruation begins, or on a specific date each month after menopause
• mammography and magnetic resonance imaging (MRI) for women at high risk
• tomosynthesis (three-dimensional mammography) is a more advanced form of traditional mammography

female health screening and assessment

vulvar self-examination

using both touch (to palpate for lumps or thickening beneath the skin) and visualization

the pelvic examination

• inspection of vagina and cervix
• Pap test- women between the ages of 21 and 65 should have a Pap test every 3 years
• HPV testing
• Pelvic exam

male reproductive system

• testes (gonads)
• scrotum- testes, the epididymis, and the vas deferens
• penis
• prostate gland
• bulbourethral (Cowper) glands

function of the organs of the male reproductive system

scrotum

holds the testes, the epididymis, and the vas deferens

functions of the organs of the male reproductive system

the spermatic cord attaches the testes to the body

it contains the blood vessels and nerves that supply the testes

functions of the organ of the male reproductive system

epididymis

a long tube that conducts sperm from the testes to the vas deferens

functions of the organ of the male reproductive system

the vas deferens

stores sperm and then carries it to the ejaculatory duct by peristaltic movements

functions of the organs of the male reproductive system

seminal vesicles

produce a fluid that is thick and contains fructose to nourish the sperm and provide energy

functions of the organ of the male reproductive system

prostate gland

produces thin, milky, alkaline secretions that contribute to the seminal fluid and enhance the mobility of the sperm

functions of the organs of the male reproductive

secretions of the bulbourethral glands

neutralize the acid of residual urine in the urethra

what is necessary for fertility?

• sexual function
• metabolism and transport of sex hormones
• cognitive and sensory centers in the brain
• sexual desire (libido)
• ability to respond to sexual stimulation with a penile erection

male contraception

reversible

• spermicidal creams, gels, or foams
• male condom

male contraception

permanent contraception

vasectomy

male health screening and assessments

testicular self- examination

regular self exams are encouraged for early detection of cancer