Gynaecological disorders including PCOS

GYNEC PROBLEMS:

Menarche (onset of menses) occurs -12.8 yrs

Common problems – delayed puberty, primary amenorrhea, abnormal uterine bleeding, dysmenorhea (pain during periods) and pelvic pain, Premenstrual syndrome.

Delayed puberty – by 16 yrs – need to be investigated

Oligomenorrhoea (decreased menstrual bleeding) – due to emotional stress, acute weight loss, excessive exercise, hyperprolactinoma, hypothyroidism.

PMS (premenstrual syndrome) There are somatic & psychological complaints – bloating, breast tenderness,food cravings, wt gain, mood swings

PCOS – presents with Type 2 DM, wt gain , pigmentation around neck, high blood pressure, high cholesterol, USG shows poly cystic ovaries.

• Leads to psychological problems-depression/ anxiety/ body dissatisfaction/decreased self esteem.
• Reproductive tract infection in 15-24yrs of age, both upper and lower RTI.
• RTI in adolescents – sexual relations are unplanned, sporadic, related to pressure, coercion, force, may start sexual activity before they achieve skill of self protection, before access to preventive services.
  Adolescent girls are vulnerable – due to immaturity of Cervix and decreased protective antibodies leading to easy penetrability of cervical mucus by organisms leading to infections and higher incidence of HIV.
  Special problems – poor menstrual hygiene, medical and psychological brunt.
  Long term sequelae leads to chronic pelvic pain, infertility, ectopic pregnan.