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Age 43: Perimenopausal stage

Increased Estrogen

Proliferation of endometrial cells

Thickening of endometrial lining

Periods of Anovulation

Absence of Progesterone to counteract Estrogen activity

Continuous proliferation of endometrial cells

Endometrium thickens further and becomes highly vascularized

Blood vessels rupture due to further thickening and increased pressure

Prolonged and profuse vaginal bleeding

Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy


(TAHBSO)

Tissue Trauma

Open Wound Disruption of Cell Membrane Nociceptors


on the dermis

Impaired Tissue Risk for Start of Inflammatory Process


Integrity Infection Send impulse to
Release of Prostaglandins/ CNS
Bradykinins
Pain on
surgical site

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