History |
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Age menarche
- 50% of cycles are anovulatory in the first 12-18 mos following menarche
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AUB Definition
- Cycle length < 21 days or > 45 days
- Duration > 7 days
- Excessive bleeding
- Blood loss > 80 mL
- Large clots > 1 inch
- Flooding accidents
- Changing soiled regular pad/tampon > every 1-2 hrs
- Symptoms of volume depletion (dizzy, syncope, fatigue)
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Assess for Bleeding Disorder
- Nosebleeds, minor cuts > 10 min, seeking care
- Bleeding w/dental extraction, surgery
- Family history
- Fe deficiency, bleeding disorder
- Post-partum hemorrhage, heavy menses
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Medications
- Hormone use, other medications
- Risk of STI, pregnancy
- Trauma
- Symptoms, suggestion of systemic disease
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Physical |
- VS, including orthostatic VS, mental status, perfusion
- Abdominal tenderness
- External genitalia
- Bleeding
- Clitoral size
- Evidence of trauma, foreign body, infection
- Pelvic exam (source/amount of bleeding)
- Thyroid enlargement
- Androgen excess: acne, hirsutism
- Bruising, petechiae
- Galactorrhea
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