1
,2
,women. Healthy BMI, preventing constipation, and treating chronic cough may also help.
Surgical repair with or without hysterectomy is the last resort.
Page-771 fig 25.11
-Dropping of the cervix or the entire uterus into the vaginal canal.
-In severe cases the uterus completely through the vagina and protrudes from the introitus.
-Symptoms of other pelvic floor disorders may also be present.
Symptoms: urinary-sensation of incomplete emptying of bladder,
incontinence,frequency,bladder splinting to accomplish voiding.
Bowel-constipation or feeling of rectal fullness, difficult defecation, stool or flatus incontinence.
*Pain or bulging includes pelvic pressure, low back pain, and vagina, bladder or rectum
bulging.
*Sexual-decreased sensation, lubrication or arousal.
-Dyspareunia
Treatment:
-Depends on age and severity.
-Isometric exercise-strengthen the pubococcygeal muscle. KEGELS*
-Estrogen-to improve tone and vascularity of fascial support POSTMENOPAUSAL*
-Pessary—a removable device to hold pelvic organs in place.
-Weight loss
-Stool softeners to avoid constipation
-tx of lung and cough conditions
PCOS
Polycystic ovary syndrome (PCOS) is a difficult syndrometo diagnose because several factors
are involved. It is a syndromein which at least two of the following are present:oligo-ovulation or
anovulation, elevated levels of androgens,or clinical signs of hyperandrogenism and
, polycysticovaries. Prolonged anovulation leads to infertility, menstrualbleeding disorders,
hirsutism, acne, endometrialhyperplasia, cardiovascular disease, and diabetes mellitus inwomen
with hyperinsulinemia.
Presenting s/s: obesity, menstrual disturbance, oligomenorrhea, amenorrhea, regular
menstruation, hyperandrogenism, infertility or they could be asymptomatic.
Diagnosis of PCOS is based on evidence of androgen excess, chronic anovulation, and
inappropriate gonadotropin secretion. Tests for impaired glucose tolerance are recommended. As
stated, polycystic ovaries do noT have to be present and, conversely, their presence alone does
not establish the diagnosis. Goals of treatment include reversing signs and symptoms of
androgen excess, instituting cyclic menstruation, restoring fertility, and ameliorating any
associated metabolic or endocrine, or both, disturbances.
*Most common cause of anovulation and ovulatory dysfunction in women.
*Leading cause of infertility and most common endocrine disturbance.
*Mostly common in younger women
*Usually has two/three of the following: irregular ovulation, elevated levels of androgens
(testosterone), and the appearance of polycystic ovaries on ultrasound.
*Polycystic ovaries do not need to be present to dx POS.
*Thyroid dysfunction, hyperprolactinemia, and congenital adrenal hyperplasia must be ruled out
first.
*Associated with metabolic dysfunction, dyslipidemia, insulin resistance, and obesity.
*Strong genetic component and possibly differentially inherited.
*Difficult to diagnose as symptoms may change over time.
*80% of women have one or more of the symptoms with normal ovaries.
*More prominent sx as we age.
*May be associated with Cushing’s syndrome, acromegaly, premature ovarian failure, obesity,
congenital adrenal hyperplasia, thyroid disease and androgen producing adrenal tumors.
Pathophysiology:
*Underlying cause is unknown
,2
,women. Healthy BMI, preventing constipation, and treating chronic cough may also help.
Surgical repair with or without hysterectomy is the last resort.
Page-771 fig 25.11
-Dropping of the cervix or the entire uterus into the vaginal canal.
-In severe cases the uterus completely through the vagina and protrudes from the introitus.
-Symptoms of other pelvic floor disorders may also be present.
Symptoms: urinary-sensation of incomplete emptying of bladder,
incontinence,frequency,bladder splinting to accomplish voiding.
Bowel-constipation or feeling of rectal fullness, difficult defecation, stool or flatus incontinence.
*Pain or bulging includes pelvic pressure, low back pain, and vagina, bladder or rectum
bulging.
*Sexual-decreased sensation, lubrication or arousal.
-Dyspareunia
Treatment:
-Depends on age and severity.
-Isometric exercise-strengthen the pubococcygeal muscle. KEGELS*
-Estrogen-to improve tone and vascularity of fascial support POSTMENOPAUSAL*
-Pessary—a removable device to hold pelvic organs in place.
-Weight loss
-Stool softeners to avoid constipation
-tx of lung and cough conditions
PCOS
Polycystic ovary syndrome (PCOS) is a difficult syndrometo diagnose because several factors
are involved. It is a syndromein which at least two of the following are present:oligo-ovulation or
anovulation, elevated levels of androgens,or clinical signs of hyperandrogenism and
, polycysticovaries. Prolonged anovulation leads to infertility, menstrualbleeding disorders,
hirsutism, acne, endometrialhyperplasia, cardiovascular disease, and diabetes mellitus inwomen
with hyperinsulinemia.
Presenting s/s: obesity, menstrual disturbance, oligomenorrhea, amenorrhea, regular
menstruation, hyperandrogenism, infertility or they could be asymptomatic.
Diagnosis of PCOS is based on evidence of androgen excess, chronic anovulation, and
inappropriate gonadotropin secretion. Tests for impaired glucose tolerance are recommended. As
stated, polycystic ovaries do noT have to be present and, conversely, their presence alone does
not establish the diagnosis. Goals of treatment include reversing signs and symptoms of
androgen excess, instituting cyclic menstruation, restoring fertility, and ameliorating any
associated metabolic or endocrine, or both, disturbances.
*Most common cause of anovulation and ovulatory dysfunction in women.
*Leading cause of infertility and most common endocrine disturbance.
*Mostly common in younger women
*Usually has two/three of the following: irregular ovulation, elevated levels of androgens
(testosterone), and the appearance of polycystic ovaries on ultrasound.
*Polycystic ovaries do not need to be present to dx POS.
*Thyroid dysfunction, hyperprolactinemia, and congenital adrenal hyperplasia must be ruled out
first.
*Associated with metabolic dysfunction, dyslipidemia, insulin resistance, and obesity.
*Strong genetic component and possibly differentially inherited.
*Difficult to diagnose as symptoms may change over time.
*80% of women have one or more of the symptoms with normal ovaries.
*More prominent sx as we age.
*May be associated with Cushing’s syndrome, acromegaly, premature ovarian failure, obesity,
congenital adrenal hyperplasia, thyroid disease and androgen producing adrenal tumors.
Pathophysiology:
*Underlying cause is unknown
