09. Menopause Flashcards
Perimenopause
Climacteric; Age-related transition from reproductive to nonreproductive state. Decreasing ovarian function starting 3-5 yrs before last menstrual period.
Menopause
Event that marks menopause is the final menstrual period. End of reproductive life. Dx if 12 consecutive months amenorrhea age > 40, OR amenorrhea (+) FSH level > 40 ng/mL
Hormone levels during Perimenopause
FSH, LH, Estrogen fluctuate but may still be NL
FSH Level changes throughout life
Childhood 30
Average age for menopause
50
First sx of ovarian failure
Hot flushes
How much does body temp rise during a hot flash?
3 degrees C
Most effective hot flash tx
Estrogen replacement
Other hot flash treatments
Progesterone; Black cohosh; Clonidine, SSRI’s, Gabapentin
Dominant form of estrogen during menopause
Estrone; converted in peripheral fat
Most potent form of estrogen
Estradiol
Where is progesterone produced?
Corpus luteum
What hormone are oocytes increasingly resistant to during perimenopause?
FSH
A woman on estrogen & progestin HRT has increased risk of which diseases?
Heart disease; CVA; VTE; Breast CA
SERMs are protective against what diseases?
Breast CA & Osteoporosis
Drug interaction with SSRIs & SNRIs
Do not give with Triptans.
What form of osteoporosis is caused by menopause?
Primary osteoporosis
Should HRT be initiated for protective effects against cardiovascular dz?
NO
What mechanism causes primary osteoporosis during menopause?
Estrogen loss sensitizes bone to respond highly to PTH. Decreased serum calcium causes PTH release to stimulate Vit. D production. High Vit D level stimulates calcium absorption and osteoclasts. WITH NO ESTROGEN, HIGH BONE CALCIUM RELEASE FOR SAME AMT OF PTH STIMULATION FURTHER WEAKENS THE STRUCTURE.
