Introduction
Medical professionals may encounter challenges in the diagnosis of gynecologic conditions due to the presence of multiple overlapping symptoms. The reviewed case study features a woman that has had prolonged menstrual bleeding along with oligomenorrhea. This report discusses the primary and differential diagnoses for the condition and suggests possible treatment methods. Also, it presents strategies aimed to enhance patients’ knowledge about perimenopause and related symptoms.
Case Study 3 Discussion
The selected case study features a 48-year-old Caucasian woman presented in the clinic with prolonged menstrual bleeding that has lasted for three weeks. Notably, the patient’s menstrual periods had been irregular for approximately eight months before the current symptom, lasting up to three days each. The woman noted that there had been one to two months when she did not have menstruation. Other symptoms include occasional hot flushes and mood changes.
The priority diagnosis for this case is perimenopause. This condition is considered the most likely diagnosis as it is characterized by hot flushes, effects on individuals’ mood, abnormally heavy bleeding, as well as shorted and missed cycles (National Collaborating Centre for Women’s and Children’s Health, 2015; Schuiling & Likis, 2017). Differential diagnoses include the following conditions:
- Polycystic ovarian syndrome, which is a common endocrine disorder that affects up to 10% of females of reproductive age and is characterized by oligomenorrhea and abnormal uterine bleeding (Lanzo, Monge, & Trent, 2015).,
- Endometrial hyperplasia, which may be defined as the thickening of the uterus’s lining. Its symptoms include vaginal bleeding between menstruations, heavy menstrual bleeding, and amenorrhea (Royal College of Obstetricians and Gynaecologists, 2016).
- Hypothyroidism, which, according to Tharpe, Farley, and Jordan (2017) may have symptoms similar to perimenopausal ones. They may include changes in mood and prolonged vaginal bleeding along with irregular periods.
Treatment and management plan for the patient in perimenopause may include the use of low-dose oral contraceptives or hormonal replacement therapy (HRT), such as estrogen 0,625mg per day and 17-beta-estradiol 1mg daily (Tharpe et al., 2017). The use of vitamin supplements, such as magnesium 400mg daily and calcium 1300mg daily may also be suggested. Alternative treatment methods include yoga, including whole grains, nuts, and seeds in the diet, and aerobic exercises. The presented treatment methods are recommended by Tharpe et al. (2017) and are considered effective for the elimination of adverse effects of the condition.
The primary strategy for educating patients on perimenopause and its effects include initiating the discussion about the common symptoms and recommendations for their relief, as well as suggestions regarding changes in the lifestyle that may improve the individual’s health outcomes. For example, a nurse may stress the significance of regular exercise, vaginal lubrication, and the decrease in alcohol and sugar intake in the elimination of the symptoms (Tharpe et al., 2017).
A caregiver should assure the patient that the vaginal bleeding, mood changes, and hot flushes are common for women in the perimenopausal period and can be managed effectively. It is also vital to inform the individual about the complications that should be reported to medical professionals, such as breast mass, depression, and unscheduled vaginal bleeding (Tharpe et al., 2017).
Conclusion
Perimenopause may have several symptoms that can also be associated with other gynecologic conditions. This paper presented an example of how the condition may be addressed and what differential diagnoses can be considered. The report showed that perimenopause might be associated with various symptoms, such as hot flushes, prolonged menstrual bleeding, mood changes, and oligomenorrhea. It concluded that it is vital to educate patients on the condition to eliminate its possible complications.
References
Lanzo, E., Monge, M., & Trent, M. (2015). Diagnosis and management of polycystic ovary syndrome in adolescent girls. Pediatric Annals, 44(9), 223-230.
National Collaborating Centre for Women’s and Children’s Health. (2015). Menopause. Full guideline. Web.
Royal College of Obstetricians and Gynaecologists. (2016). Management of endometrial hyperplasia. Web.
Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.
Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.