Term
|
Definition
| physical and behavioral symptoms that occur repetitively in the SECOND HALF of the menstrual cycle |
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Term
|
Definition
| most sever form of PMS, quality of life is significantly affected |
|
|
Term
|
Definition
| not fully known, interaction of hormones and seratonin NT, hypothalamic-pituitary-gonadal (HPG) axis involvement, stress and poor eating habits |
|
|
Term
| 2-3 days after menses begin |
|
Definition
| symptoms of PMS/PMDD subside |
|
|
Term
| 7-10 days before start of next period (days 14-28 in a 28 day cycle) |
|
Definition
| luteal phase in which common symptoms of PMS/PMDD begin |
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|
Term
| less mood symptoms and daily activity impairment |
|
Definition
|
|
Term
|
Definition
| increase complex carbs, increase aerobic exercise, nutritional supplements, and reduce alcohol, caffeine, salt, and smoking, increase adequate sleep |
|
|
Term
| modification of neurotransmitters |
|
Definition
| sertraline or fluoxetine (SSRIs) and consider anxiolytic for specific symptoms for those who do not respond |
|
|
Term
| hormonal ovulation suppression or removal of ovaries |
|
Definition
| oral contraceptives or GnRH agonists (Lupron) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| caffeine restriction, Vit E and NSAID |
|
|
Term
|
Definition
| caffeine restriction and NSAID |
|
|
Term
|
Definition
| caffeine restriction, melatonin |
|
|
Term
|
Definition
| Na restriction, spironolactone |
|
|
Term
|
Definition
| caffeine restriction, SSRI |
|
|
Term
|
Definition
| irritability/anger, low self esteem, oversensitivity, crying episodes |
|
|
Term
|
Definition
| fluoxetine, sertraline and paroxetine |
|
|
Term
|
Definition
| faster onset than depression, can be given intermittently or continuously |
|
|
Term
|
Definition
| sedation, GI, HA, nervousness, sexual dysfunction and fatigue |
|
|
Term
|
Definition
| period of time for switching from fluoxetine to MAOI |
|
|
Term
|
Definition
| period of time for switching from MAOI to fluoxetine |
|
|
Term
|
Definition
| can be activating so take in the morning |
|
|
Term
| counseling for paroxetine |
|
Definition
| most sedating and most anticholinergic (dry mouth and urinary retention) |
|
|
Term
| advantages of SSRI over TCAs |
|
Definition
| less sedating, less wt gain, CV changes and anticholinergic effects |
|
|
Term
| other antidepressants used |
|
Definition
| more SEs, less effective for indication |
|
|
Term
| serotonergics used alternatively to SSRI for PMDD |
|
Definition
| nefazodone and venlafaxine |
|
|
Term
| TCA-5HT and NE reuptake inhib used alternatively to SSRI for PMDD |
|
Definition
| clomipramine and nortryptyline |
|
|
Term
| TCA-5HT and NE reuptake inhib SEs |
|
Definition
| anticholinergic, QT prolongation, orthostatic hypotension, tachycardia |
|
|
Term
|
Definition
|
|
Term
| alprazolam for PMDD-associated anxiety |
|
Definition
| potentiate GABA, causing CNS depression; quick onset, sedation, reduce, cognitive and motor skills, dependence/ tolerance...should be used short term use recommended |
|
|
Term
| buspirone-5HT partial agonist for PMDD-associated anxiety |
|
Definition
| no sedation or cognitive impairment, no abuse of physical dependence, avoid use with MAOIs; Nausea, HA,light headedness |
|
|
Term
|
Definition
| diphenhydramine, TCAs, and trazadone |
|
|
Term
| TCAs for PMDD-associated insomnia |
|
Definition
|
|
Term
| Trazadone for PMDD-associated insomnia |
|
Definition
| serotonin receptor antagonist; orthostatic HypoTN, GI SEs |
|
|
Term
|
Definition
| spironolactone (first line), HCTZ, metolazone, triamterene |
|
|
Term
| YAZ (ethinyl estradiol and drospirenone) |
|
Definition
| improved mood and physical symptoms, hyperkalemia, increased clotting |
|
|
Term
| alternative hormonal contraceptive |
|
Definition
| estradiol implants, high doses of progesterones, and GnRH-As |
|
|
Term
|
Definition
| GnRH agonist regulating release of FSH and LH from pituitary which inhibits the normal menstrual cycle/hormone fluctuation |
|
|
Term
|
Definition
| menopausal symptoms, osteoporosis and CV disease |
|
|
Term
| common analgesic and anti-inflam agents (natural) |
|
Definition
| evening primrose oil and ginko |
|
|
Term
| natural antidepressant agents |
|
Definition
| 5-HTP, L-tryptophan, SAMe, St. John's wart |
|
|
Term
|
Definition
| black cohosh, chasteberry, Dong quai, progesterone, red clover, and soy glycine max |
|
|
Term
|
Definition
| water retension, food cravings, pain and emotional symptoms |
|
|
Term
|
Definition
| fluid retention, bloating |
|
|
Term
|
Definition
| depression, fatigue, irritability and HA |
|
|
Term
|
Definition
|
|
Term
| manganese and potassium benefits |
|
Definition
|
|
Term
|
Definition
| SSRIs, Leuprolide, OCs, TCAs and vit/mineral |
|
|
Term
|
Definition
| NSAIDs, Alprazolam, Spironolactone, Diphenhydramine |
|
|
Term
|
Definition
| should receive only estrogen |
|
|
Term
|
Definition
| should receive BOTH estrogen and progestin |
|
|
Term
|
Definition
| endometrial cancer, increased cardiovascular outcomes |
|
|
Term
|
Definition
| estrogen daily, progestogen co-admin 12-14 days of the 28 day cycle |
|
|
Term
|
Definition
| results in absence of vaginal bleeding but spotting can occur |
|
|
Term
|
Definition
| designed to decrease uterine bleeding |
|
|
Term
|
Definition
| pulse progestogen; 3 days of estrogen only then 3 days of combo and repeat: prevent down regulation of progestogen that can occur with continuous combined regimen |
|
|
Term
| bio-identical hormon replacement therapy |
|
Definition
| synthetic hormone replacement with similar chemical structure to human hormone; no confirmed benefit but some suggest it is safer |
|
|
Term
| non-HRT pharmacotherapy alternatives |
|
Definition
| SSRIs, Megestrol, clonidine, gabapentin |
|
|
Term
|
Definition
| ovaries stop producing eggs and menstrual cycle stops |
|
|
Term
|
Definition
| serum inhibin B begins to decrease, serum FSH increases slightly, estradiol levels are preserved, luteal progesterone levels decrease as fertility potential begins to decline |
|
|
Term
|
Definition
| lengthening of intermenstrual interval, early folicular phase FSH levels are high but variable |
|
|
Term
| after lengthening of intermenstrual interval more dramatic menstrual cycle changes |
|
Definition
| skipped cycles, episodes of amenorrhea, increased freq of anovulatory cycles |
|
|
Term
|
Definition
| short-term for hot flashes and sweating and vaginal atrophy, osteoporosis |
|
|
Term
|
Definition
| BOTH estrogen and progestin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| prevents endometrial hyperplasia, usually administered 12-14 days per mo |
|
|
Term
|
Definition
| mood swings, bloating, sleep distrubances, irritability, depression HA |
|
|
Term
|
Definition
| N, HA, breast tenderness, heavy bleeding |
|
|
Term
| medroxyprogesterone acetate |
|
Definition
|
|
Term
|
Definition
| medroxyprogesterone + estrogen |
|
|
Term
|
Definition
| no return of menopausal symptoms because constant E, bleeding each month continues |
|
|
Term
|
Definition
| most women experience amenorrhea for one year, umpredictable spotting or breakthrough bleeding when therapy initiated |
|
|
Term
| Continuous long cycle E+P |
|
Definition
| E constant, P given 6 times per year for 12 intervals; known bleeding times, still causes withdrawal bleeding that is heavier than cyclic P |
|
|
Term
|
Definition
| goes to testosterone goes to estrogen |
|
|
Term
|
Definition
| selective estrogen receptor modulator |
|
|
Term
| indications for raloxifene |
|
Definition
| invasive breast cancer in postmenopausal women with or without osteoporosis |
|
|
Term
|
Definition
| prevention of osteoporosis (30-50%), decrease in LDL and total cholesterol, decrease incidence of breast cancer and increase risks of VTE and stroke |
|
|
Term
|
Definition
| bisphosphonates and Denosumab (Prolia) |
|
|
Term
|
Definition
| decrease in vertebral and hip fractures, no impact on CVD or breast/ endometrial CAs |
|
|
Term
| side effects of bisphosphonates |
|
Definition
| GI effects, osteonecrosis of jaw and femur fractures |
|
|
Term
|
Definition
| common cause of chronic pelvic pain in women, associated with infertility; charaterized by the presence of endometrial tissue outside the uterus, chronic, reoccurring disease |
|
|
Term
| endometriosis-associated pain is secondary to structural or inflammatory cause |
|
Definition
| direct compression of nerve fivers or increased pressure within endometriosis |
|
|
Term
| symptoms of endometriosis may correlated with the cyclic release of hormones during the menstrual cycle |
|
Definition
| endometrial lesions contain estrogen and progesterone receptors |
|
|
Term
|
Definition
| infertility may result from distortion of the pelvic structure secondary to endometrial lesions, inflammation and adhesion |
|
|
Term
| symptoms of endometriosis |
|
Definition
| asymptomatic, to dispareunia, chronic pelvic pain (cyclic/acyclic) premenstrual spotting, GI disturbance, urinary distrubance, lower back pain and infertility |
|
|
Term
| treatment goals for endometriosis |
|
Definition
| removal of deposits, prevention of progression, minimize pain, prevent or correct associated infertility |
|
|
Term
| treatment for endometriosis |
|
Definition
| NSAIDs, combined hormone contraceptives, GnRH agonist |
|
|
Term
|
Definition
| inhibits FSH and LH which diminishes endometrial implants |
|
|
Term
| Leuprolide, Goserelin, Nafarelin |
|
Definition
|
|
Term
|
Definition
| hypogonadism; used for surgeries, increasing muscle mass in men, libido, energy etc. but controversial in "androgen deficient" women |
|
|
Term
| risk of testosterone therapy |
|
Definition
| increased risk of prostate cancer, liver damage and increased cholesterol |
|
|
Term
| testim gel, andro gel, androder patch, axiron, striant buccal tabs |
|
Definition
|
|
Term
| black box for testosterone |
|
Definition
| worsens signs and symptoms of BPH, secondary exposure of risk |
|
|
Term
| side effects of testosterone |
|
Definition
| increase creatinine, appetite, sensitive nipples, acne, hepatotoxicity; not to be used in women or children due to developmental risks and defects in unborn babies |
|
|
Term
| side effects of topical testosterone |
|
Definition
| can burn skin when wearing it during MRI and flammable, wait until dry before going near open flame or smoke |
|
|
Term
| does NOT increase with combined hormone replacement therapy used for menopause |
|
Definition
|
|
Term
| combined hormone therapy replacement for menopause results in |
|
Definition
| increased rate of dementia, greatest risk of invasive breast cancer in 1st year, greatest risk of VTE seen after more than 3-5yr therapy |
|
|
Term
| used to offset Goserelin side effects |
|
Definition
| low dose progesterone or combo HTR |
|
|
Term
| polycystic ovary syndrome associated with |
|
Definition
| obesity, alopecia, hirutism, infertility |
|
|
Term
|
Definition
|
|
Term
| for treatment of PCOS, combined HRT can be given with |
|
Definition
|
|
Term
|
Definition
| only med in class that is intranasal |
|
|
Term
| GnRH are FDA approved for use |
|
Definition
| for one year (limit to <6 mo) |
|
|
Term
| caffeine does NOT improved |
|
Definition
| vasomotor symptoms of menopause |
|
|
Term
| common side effects of GnRH |
|
Definition
| hirsutism, bone demineralization, vasomotor symptoms |
|
|
Term
|
Definition
|
|
Term
| increased risk associated with combo HRT |
|
Definition
|
|
