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Urogenital System > 16. The Climacteric > Flashcards

16. The Climacteric Flashcards

1
Q

Define the Climacteric Stage

A

Transition from reproductive to non-reproductive state

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2
Q

Define menopause

A

Permanent cessation of menstruation

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3
Q

When does menopause occur

A

After 12 consecutive months of amenorrhea for which there is no other pathologic or physiologic cause

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4
Q

At which median age does menopause occur

A

51.4 yrs

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5
Q

Is menopause before 40 normal?

A

No it is pathological and is termed premature

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6
Q

When does the Climacteric start

A

4 yrs prior to the last menstrual period

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7
Q

At which stage in utero do females have 6-7 million primordial follicles?

A

16 weeks

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8
Q

By 16 weeks in utero, there are how many primordial follicles in the female baby

A

6-7million

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9
Q

Approximately how many oocytes does the average female have at puberty

A

300,000

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10
Q

True or false

The number of follicles in the ovary determines the age at which the menopause takes place

A

True

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10
Q

True or False
Oral Contraceptives affect the number of oocytes present at a stage of life

A

False

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11
Q

List eight sites of Oestrogen Receptors

A 
Urogenital Tract
Breasts
Bones
Skin
Most connective tissue
Cardiovascular system
Liver 
CNS
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12
Q

What happens to FSH and LH levels 2-3 yrs before menopause

A

Levels increase

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13
Q

FSH and LH levels increase how long before the onset of menopause

A

2-3yrs

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14
Q

What is the effect of menopause in Estradiol levels

A

Levels decline

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15
Q

Estradiol levels decline how long before menopause

A

6 months

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16
Q

After menopause what happens to FSH and LH levels

A

The levels continue to rise

(X20 increase in FSH)
(X3 increase in LH)

Peaks 1-3 yrs after menopause onset

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17
Q

What is the effect of menopause on Androgen producing Theca cells

A

They continue to produce androgens, they just produce less

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18
Q

Decrease in which hormone contributes to the decreased sexual function in post menopausal women

A

Decreased Androgens

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19
Q

What is the normal menstrual cycle for ovulatory women

A

28+/- 7 days

Lasting 5+/- 2 days

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20
Q

True or False

Menopause is consistently proceeded by a period of prolonged cycle intervals

A

True

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21
Q

What is the role of estrogen in the menstrual cycle

A

Inhibits FSH

:. During menopause there is decreased estrogen and the pituitary gland “flogs” the struggling ovary with as much FSH possible to stimulate growth

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22
Q

During the Climacteric before menopause the menstrual cycle increases from 25-35 days to …

A

Uo to 40-50 days and the periods appear skipped

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23
Q

What are two vasomotor symptoms of Menopause

A

Hot flashes and Night sweats

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24
Q

What is the most common symptom of menopause

A

Hot flashes

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25
Q

Describe the term Hot Flashes

A

Sudden onset of a sensation of heat, sweating, and flushing

26
Q

How long do hot flashes last

A

2-4 minutes

27
Q

What are “Night Sweats”

A

Hot flashes that occur at night usually while a woman is sleeping

28
Q

Which risk factors of a female affects the severity of the Vasomotor Symptoms Associated with menopause

A

Ethnicity (African and Latin America more than Asian women)

Early age of menarche and menopause onset

History of irregular menses

Increased BMI

Social drugs (alcohol and cigarette use)

29
Q

How long does it take for Postmenopausal sympotoms to spontaneously resolve

A

The symptoms resolve spontaneously within 5yrs

30
Q

Vasomotor symptoms of Menopause persists for decades or becomes lifelong in what percentage of women

A

10-15%

31
Q

What is the most effective treatment available for hot flashes

A

Hormone Replacement Therapy

(alpha adrenergic agonists, and serotonin reuptake inhibitors can be used)

32
Q

What are two urogenital effects of vaginal dryness

A

Itching, dyspareunia

33
Q

What are two Urogenital Symptoms of Menopause

A

Vaginal Dryness

Urinary Incontinence

34
Q

What leads to urinary incontinence in Menopausal women

A

Atrophy of the urethral mucosa and the trigone, resulting in less control over bladder function

35
Q

What causes the decreased lubrication of vagina and vulva in menopause

A

Low estrogen levels which cause decreased blood flow to vulva and vagina

36
Q

What change is seen in the cervix during menopause

A

The cervix atrophies and becomes flush with the vaginal vault, less cushioning

37
Q

What changes are seen in the vagina during menopause

A

Decreased elasticity with vagina becoming shorter and shorter

38
Q

True or False

Depression occurs more frequently in women

A

True

39
Q

Women lose what percentage of their trabecular bone during their lifetime

A

Approximately 50%

40
Q

Women lose what percentage of their cortical bone during their lifetime

A

Approximately 30%

41
Q

Half of the bone material lost during the lifetime of a female is lost when?

A

During the first 10 years after menopause

42
Q

There is about what percentage increase in Low Density Lipoproteins in Postmenopausal women

A

6%

43
Q

What value of Serum FSH in UI/ml implies menopause

A

> 50 IU/ml

44
Q

When is FSH test for menopause taken (which day of the cycle)

A

Day 2 or 3

45
Q

Oestradiol can be measured using which samples

A

Serum
Urine
Saliva

46
Q

A serum estradiol level less than what value can diagnose Menopause

A

<50pg/mL

47
Q

Hormonal Replacement Therapy treatment for Menopause, uses which Hormone

A

Estrogen

48
Q

Estrogen therapy for menopause treats menopausal symptoms by:

A

Reducing the frequency of hot flashes by 77%

Decreasing symptoms associated with vulvovaginal atrophy

49
Q

What are the administration methods for Hormonal Replacement Therapy

A

Transdermal patch
Oral
Topical as creams

50
Q

If a patient opting for Hormonal Replacement Therapy with Estrogen has a uterus, the Estrogen should be administered with what?

A

Progestin

To prevent endometrial hyperplasia

51
Q

NB//

Estrogen should be started on low doses and used for less than a 1yr/2 yr period and then tapered off the Medicine

A

Okay😉

52
Q

The decision to use Hormone Replacement Therapy depends on what factors?

A

Current Health Status
Personal Health History
Family Health History

53
Q

Here are a few ABSOLUTE contraindications for Hormonal Replacement Therapy

A 
Breast Cancer. (Current, past or suspected)
Estrogen-sensitive malignant conditions (known or suspected)
Undiagnosed genital bleeding
Untreated Endometrial hyperplasia
Venous Thromboembolism 
Thromboembolic disease
Untreated hypertension
Active Liver Disease
54
Q

List 7 complementary and alternative medicine (CAM) therapies that exist

A 
Stress management 
Nonprescription remedies
Chiropractic and Naturopathic care
Massage Therapy
Dietary soy 
Herbs
Acupuncture
55
Q

List one conventional drug used to treat Postmenopausal symptoms

A

Clonidine

56
Q

Which 2 selective serotonin re-uptake inhibitors are used in Alternative therapy treatment for Postmenopausal symptoms

A

Gabapentine

Venlaxafine

57
Q

List four herbs/ natural sources of estrogen

A

Soy
Yams
Evening Primrose
Red Clover

58
Q

What is the result of an overall decrease in Androgen levels in the Postmenopausal woman

A 
Decreased libido
Decreased sexual response
Decreased sense of well being
Poor concentration 
Fatigue
59
Q

List three pharmacologic products that are effective in fracture prevention of the Postmenopausal woman

A

Bisphosphates
Parathyroid hormone
Calcium plus Vitamin D

60
Q

List two non pharmacologic intervention of fracture prevention in Postmenopausal women

A

Regular Exercise

Reduce risk for fractures secondary to osteoporosis

61
Q

Postmenopausal women should be screened for:

A

Cardiovascular disease
Cancer
Osteoporosis

62
Q

Which cancers should Postmenopausal women be screened for

A

Colon
Ovarian
Uterine
Breast

Urogenital System (17 decks)

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