title: Gynecological health of females with congenital heart disease.
abstract: Because of major advances in diagnostic and surgical methods, females with congenital heart disease (CHD) now survive into and beyond their reproductive years. Management of pregnancy in this patient population is well described, but gynecologic management such as menstruation, contraception and menopause have received scanty attention. Accordingly, the gynecologic health issues confronting these patients are described. Menstrual patterns in acyanotic females with CHD are similar to the general population, but cyanotic females have menstrual irregularities including amenorrhea, which implies anovulation and an increased risk of uterine carcinoma. Anticoagulants predispose to heavy vaginal bleeding and corpus luteum rupture. Contraceptives must be selected according to individual patient profiles. Hormone replacement therapy is warranted for relief of menopausal symptoms as in the general population and should be relatively safe because estrogen dose is low.
authors.affiliation: Ahmanson UCLA Center for Adult Congenital Heart Disease, UCLA School of Nursing, Box 951702, Los Angeles, CA 90095, USA. mcanobbi@sonnet.ucla.edu
authors.forename: Mary M
authors.initials: MM
authors.lastname: Canobbio
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Perloff
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Rapkin
mesh_terms: D000028:Abortion, Induced; D015897:Comorbidity; D003267:Contraception; D044363:Contraception, Postcoital; D005260:Female; D006304:Health Status; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007434:Intrauterine Devices; D008598:Menstruation / Q000502:physiology*; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000503:physiopathology