1. Ammenorrhea: primarysecondary
2. Discharge
3. Dysmennorhea
4. Infertility
5. Mennorhagia/oligomennorhea
6. Pelvic pain
7. Pelvic mass
8. Prolapse
9. Urinary: incontinenceother problems

Amenorrhea: primary

• Stature (TurnersKleinfelter's)
• Puberty development (pituitary)
• Monthly abdominal paindysuria (imperforate hymen)
• Drugs (drugs)

Amenorrhea: secondary

• LMPbreast tinglingabdominal swellingmorning sickness (pregnant)
• Recently stopped taking OCP (some months to recover)
• Weighthirsuitismmale pattern baldnessvoice deepening (PCOS)
• Stressrecent weight loss (decresed GnRH release)
• Recent hemorrage-complicated pregnancy (Sheehan's)
• Recent D&C (Asherman's)
• Galactorrheavisual disturbanceheadaches (hyperprolactinemia)

Discharge

• Itchiness
• Blood stained (carcinoma)
• Onsetduration
• Amount: pad/tampon required
• Relation to menses

Dysmennorhea

• Character: constantdull (congestive) vs. bouts (spasmodic)
• Alleviating: previous Tx tried
• Timing: relation to periods
• Exacerbating: sex
• Severity: increasing vs. decreasinglost workinterference with life
• Depressionheadachesirritability (regular PMS)

Infertility

• Primary [no prior pregnancy] vs. secondary [prior pregnancy]
• Health of partner (prior kidsagegenital operations)
• Coitus: frequencydifficulties
• Hx of gynecological dz: STDssalpingitis
• Hx of systemic dz: TBhypothyroidism
• Hx of abdominal operations: D&Cappendicitisothers (adhesions)

Mennorhagia/oligomennorhea

• Menses: cycle lengthdurationregular vs. irregular
• Heaviness: number of padsiron supplements
• Clotsflooding
• Intramenstrual bleedingpoistcoital bleeding
• Pain
• Influence on lifestyle
• Prior Hxand effectiveness of any OCPD&C

Pelvic pain

• Siteonsetcharacterradiationtimingseverity (during sleep and work)
• Alleviatingexacerbating factors (mensesposturecoitus [deep/supercial]defecationtime of day)

Pelvic mass

• Pregancy
• Rapid size increase (malignant ovarian)
• Painless (pregnancymost benign) vs. painful (most malignants)
• Weight loss (malignancy)

Prolapse

• Onsetduration
• Alleviating: lying down (any prolapse)
• Exacerbating: prolonged standing (any prolapse)
• Severity: discomfortinterruption to life
• Defecation difficultly (rectocele)
• Urinary incontinence

Urinary: incontinence

• Wet when coughsneeze laugh (stress incontinence)
• Chronic cough (stress incontinence)
• Wet before reaching toilet (urgency incontinence)
• Increased frequency (urgency incontinence)
• Wet at night (enuresisurinary fistula)

Urinary: other problems

• Colour change
• Blood in urine
• Frequencyamount changes
• Painburning sensation
• Feeling of incomplete emptying
• Hesitancynocturiadribbling

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