1. Disorders of menstrual cycle

2. hypermenorea heavy bleeding hypomenorea small bleeding

3. menoragie heavy and long bleeding

4. Before During Post ………………………….. Bleeding

5. poruchy rytmu cyklu polymenorea short menstrual cycle oligomenorea long cycle

6. amenorrhoea no bleeding oprimary Osecundary

7. metrorhagie irregular long and heavy bleeding

8. Premenstrual syndrom -25-33% of the female population 30-45 years Definice : cyklic, repetitive – changes - -second half of hte cycle

9. : Type I.- in the midlle of the cycle Type II.- second third of the cycle Type III.- midlle and second half Type IV.- same as typ I + peri menstrual period

10. ETIOLOGY High oestrogens, low progesterons High oestrogens, low progesterons Hyperprolaktemy Hyperprolaktemy hypokalcemie, deficit vitamins hypokalcemie, deficit vitamins High aldosteron, higher activity renin angiotensin system High aldosteron, higher activity renin angiotensin system

11. Clinic Depresion, anxiety, Depresion, anxiety, Breast pain Breast pain Oedemas Oedemas GIT issues GIT issues Head ache Head ache

12. Examination Ultrasound Ultrasound Organic issues (hyperprolaktemy, endometriosis) Organic issues (hyperprolaktemy, endometriosis)

13. Therapy Non- farmacologic Non- farmacologic Dealing with organic issues …. Dealing with organic issues …. Dietetic and water metabolism Dietetic and water metabolism

14. Farmacological therapy -diuretics -nesteroid antiflogiscs (dysmenorea) -bromokriptin (breast pain) -suplementation of the Ca2+

15. Therapy hormones: hormones:-COC, -gestagens (Depo-provera) -Analogs GnRh -Psychopharmac- (SSSRI- sentralin, citalopram) -surgery – bilateral oophorektomy