Men & Women's Health
Perimenopause - ANS-1st signs on changes in the menstrual cycle
Ends with complete cessations of cycles into menopause
Menopause - ANS-Cessation of menses associated with declining ovarian function
Gradual changes: flow becomes heavier, lighter, or irregular before stopping
Complete after 1 full year of no menses
Menopause: Patho - ANS-Regression of follicles within each ovary, accelerates after 35
years
FSH stimulates follicles to secrete estrogen, decreased responsiveness in menopause
Menopause Manifestations - ANS-Hot flashes, night sweats
Vaginal dryness
Urgency frequency
Mood and sleep changes
Increased rate of fractures
Breast tissue changes & tenderness
Estrogens - ANS-Responsible for maintenance and development of the female and
reproductive system, female secondary sex characteristics
Estrogen contraindications - ANS-Contraindication: any estrogen-dependent cancer,
pregnancy, any clotting history
Adverse effects: **Thrombolytic events**, nausea, uterine bleeding, tender breasts
Progestins (progesterone) - ANS--Induces secretory changes in uterine lining
-Indicated in bleeding, hormonal imbalances, uterine and endometrial cancer,
amenorrhea
Same contraindications as estrogens
Estrogen/Progesterone - ANS-Short term use!! (4-5 years)
Risks: increased breast and endometrial cancers, clots-TUMOR PROMOTERS
Decreases osteoporosis, symptom management
Hormonal nursing implications - ANS-Take smallest dose as needed !!
Give IM doses deep into large muscle
Give orals with meals, reduce GI upset
, May increase photosensitivity
Continue PAP smears and self-exams
Medroxyprogesterone (Depo-provera) - ANS-Inhibits follicular maturation, prevents
ovulation
IM injection only
Endometeriosis - ANS-Presence of endometrial tissue in sites outside the endometrial
cavity
Caused by retrograde menstrual flow through Fallopian tube, viable endometrial tissue
attaches to tissues
Endometriosis Manifestations - ANS-Dysmenorrhea, infertility
Pelvic pain, painful intercourse
Irregular bleeding
Lower back pain
Pain with BM
Dysuria
Symptoms disappear with menopause
Endometriosis treatment - ANS-Goal= reduction of symptoms
Pain=NSAIDS
Oral contraceptives- continuous use causes regression of endometrial tissue, takes
about 9 months
Cervical Cancer: Manifestations - ANS--None early
-Unusual, foul smelling discharge
-Postcoital bleeding
-Spotting frequency, heavy bleeding
-Pain, anemia, weight loss, cachexia late stage
Cervical Cancer: Screening - ANS-Regular PAP smears to identify change in
appearance to cervical cells
Primary prevention = HPV vaccination
Endometrial Cancer - ANS-◦ Most common gynecological cancer
◦ Arises from endometrium
‣ Can spread to myometrium, lymph nodes, metastasis
First sign = abnormal bleeding
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