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INFERTILITY
• Infertility is the inability to achieve a pregnancy after at least 1 year of regular intercourse
without contraception.
• Diagnostic studies include ovulatory studies, tubal patency studies, and postcoital studies.
Management depends on the cause and can include supplemental hormone therapy and
antibiotic therapy.
ABORTION
• Abortion is the loss or termination of a pregnancy before the fetus has developed to a state
of viability.
• Nursing management includes the use of comfort measures to provide needed physical and
mental rest. The support of the patient and her family is essential.
PREMENSTRUAL SYNDROME
• Premenstrual syndrome (PMS) is a common disorder of physical and psychologic
symptoms during the last few days of the menstrual cycle and before onset of menstruation.
• Physical symptoms include breast discomfort, abdominal bloating, sensation of weight gain,
episodes of binge eating, and headache. Anxiety, depression, irritability, and mood swings
are some of the emotional symptoms.
DYSMENORRHEA
• Dysmenorrhea is abdominal cramping pain or discomfort associated with
menstrual flow.
o Primary dysmenorrhea is caused by an excess of prostaglandin F2α (PGF2α) and/or
an increased sensitivity to it.
o Secondary dysmenorrhea is acquired after adolescence; pelvic causes include
endometriosis, chronic pelvic inflammatory disease, and uterine fibroids.
• Treatment for primary dysmenorrhea includes heat, exercise, and drug therapy. For
secondary dysmenorrhea, it depends on the cause.
ECTOPIC PREGNANCY
• An ectopic pregnancy is the implantation of the fertilized ovum anywhere outside the
uterine cavity.
• Any blockage of the tube or reduction of tubal peristalsis that impedes or delays the zygote
passing to the uterine cavity can result in tubal implantation.
• Risk factors include a history of pelvic inflammatory disease, prior ectopic pregnancy,
current progestin-releasing intrauterine device (IUD), progestin-only birth control failure,
and prior pelvic or tubal surgery.
• Eventually the tube ruptures with acute peritoneal symptoms of abdominal/ pelvic pain,
missed menses, and irregular vaginal bleeding. Less acute symptoms begin 6 to 8 weeks
after last normal menstrual period.
MENOPAUSE
• Menopause is the physiologic cessation of menses associated with declining ovarian
function. It is usually considered complete after 1 year of amenorrhea.
• Premenopausal symptoms include hot flashes, irregular vaginal bleeding, fat redistribution,
and a tendency to gain weight.
• Treatment might include hormone replacement, drug therapy, and alternative therapies.
• Abnormal vaginal discharge and reddened vulvar lesions are often noted with itching and
dysuria.
• Long-term complications include ectopic pregnancy, infertility, and chronic pelvic pain.
ENDOMETRIOSIS
• Endometriosis is the presence of normal endometrial tissue in sites outside endometrial
cavity.
• One cause is retrograde menstrual flow through the fallopian tubes carrying viable
endometrial tissues into the pelvis.
• Symptoms are secondary dysmenorrhea, infertility, pelvic pain, dyspareunia, and irregular
bleeding.
LEIOMYOMAS
• Leiomyomas (uterine fibroids) are benign smooth-muscle tumors that occur within the
uterus.
CERVICAL CANCER
• There is a strong relationship between sexual exposure of papillomavirus (HPV) and
dysplasia.
ENDOMETRIAL CANCER
• The major risk factor of endometrial cancer is unopposed estrogen.
OVARIAN CANCER
• The etiology of ovarian cancer is generally not known.
• In the early stages, manifestations are vague and may consist of abdominal discomfort (gas,
indigestion, pressure, bloating, cramps) and change in bowel habits.
• Nurses can teach women importance of routine screening for cancers of the reproductive
system.
UTERINE PROLAPSE
• Uterine prolapse is the downward displacement of uterus into the vaginal canal.
• Symptoms are dyspareunia, dragging or heavy pelvic feeling, backache, and bowel or
bladder problems if cystocele or rectocele is also present.
• Therapy depends on degree of prolapse and can include strengthening exercises, and a
pessary.
SEXUAL ASSAULT
• Sexual assault is the forcible perpetration of a sexual act on a person without his or her
consent. It can include sodomy, forced vaginal or anal intercourse, oral copulation, and
assault with a foreign object.
• Physical injuries may include bruising and lacerations to perineum, hymen, vulva, vagina,
cervix, and anus.
• Ensuring the woman’s emotional and physical safety is the highest priority.
• BPH results from endocrine changes associated with the aging process.
• The compression of the urethra leads to clinical symptoms including decrease in caliber and
force of the urinary stream, difficulty in initiating voiding, intermittency and dribbling.
• Conservative and initial treatment is “watchful waiting” when there are no symptoms or
only mild ones. Drug therapy may also be used.
PROSTATE CANCER
• Prostate cancer is the most common cancer among men, excluding skin cancer.
• Invasive therapies include radical prostatectomy and cryosurgery. Treatment may also
include drugs, hormones, chemotherapy, and radiation.
• The nursing role is to encourage patients, in consultation with health care providers, to have
annual prostate screening (PSA and digital rectal examination) starting at age 50 or younger
if risk factors present.
PROSTATITIS
• The term prostatitis describes a group of inflammatory and noninflammatory conditions
affecting the prostate gland.
EPIDIDYMITIS
• Epididymitis is an acute, painful inflammatory process of the epididymis secondary to an
infectious process, trauma, or urinary reflux down the vas deferens.
• Antibiotic use is important for both partners if transmission was through sexual contact.
• Conservative treatment consists of bed rest with elevation of scrotum, use of ice packs, and
analgesics.