18 - Menopause Flashcards
Menopause difinitions and terms:
Menopause: Time following 1 yr of complete cessation of menstruation
Post menopause: time after
Average age: 51
Premature ovarian failure: menopause <40
Menopausal transition?
- Premenopausal or climacteric changes
- 42-58 y/o
- begins w menstrual irregularity UTC
- average = 4-7 yrs
Stages of menopause?
Stage 5 - early reproductive period Stage 4 - reproductive peak Stage 3 - late reproductive period Stage 2 - early menopausal transition Stage 1 - late menopausal transition Stage + 1a - 1st yr after FMP (final menses) Stage + 1b - yrs 2-5 post menopause Stage + 2 - later menopausal yrs
Chart on 380 (review) with a big old pink star on it maybe important (honestly who knows w her)
Factors that hasten menopause?
Smoking hastens by 2 yrs
Chemo
Radiation
Ovarian surgery
Menopausal transition sx?>
Menstrual pattern - shorter/longer, irregular Vasomotor - hot flashes etc Psychological/cognitive - PMS, depression, mood swings Sexual dysfunction - dry vag, L libido, dyspareunia Somatic - HA, dizziness, palpitations Other - list of shit to bitch about
Early vs late menopausal transition?
Early
- cycle irregular (7+ days off) (usually shorter)
- FSH and estridiol levels increase
- anovulation mixed w regular cycle (surprise babies happen here)
Late menopausal transition
- > /= 2 skipped menses
- 1+ interval = 60+ days (longer periods of anovulation)
Menopausal physiologic changes?
FSH/LH increase Estrogen/progesterone decrease Central thermoregulation Cardiovascular changes Wt gain/fat distribution Derm changes Dental changes CNS changes Psychosocial changes Breast changes Lower reproductive tract changes GU changes Lipido changes Bone and metabolism
When can women stop contraception?
Should be safe after 55
- no spontaneous pregnancies above age of 55 reported
- menses may continue past 55 but rarely include ovulation
MCC of erratic bleeding during menopause?
Anovulation
Typical Hot flashes
Typicall last 1-5 min - skin tepm 10-15C change - sweating - increase BP 30 min to return to normal
Approx 2 years before FMP
Thermoregulation changes are associated with?
Race
AA>Caucasian>asian
Low exercise Smoking H FSH L estradiol BMI Lower socioeconomic status Premenstrual dysphoric d/o PMDD Depression
Cardio changes w menopause/?
Estrogen is cardioprotective
- it goes away, so does its protection
CVD = leading cause of death > 50
Derm changes of menopause?
Age spots - hyperpigmentation
Decreased elasticity
Lower collagen content
Decreased blood supply
Dental changes of menopause?
Buccal epithelium atrophies (w reduced estrogen)
Increased cavity risk
Bad taste in mouth
Osteoporosis -> tooth loss
CNS changes?
Sleep quality decrease
Lighter sleeper
- esp to pain
Cognitive function decrease
Psychosocial changes?
Women have more depression than men
She says it may have to do with their perceived role of bearing children or their lack of children during life
Now their chances are gone and all is lost or some such shit.
- her words not mine (slide 390)
Breast changes
Hormonal withdraw leads to breast tissue swapping for adipose tissue
Lower reproductive changes?>
Muscle decrease
- susceptible to estrogen deprivation
GU symptoms of menopause?
Dryness/lubrication Dyspareunia Postcoital bleeding Poor arousal Vulvovaginal itching, burining Dysuria Urinary frequency/urgency J
GU signs?
Labia minor resorption Narrowed introitus Absent hymenal tags Tissue pallor/erythema Urethral eversion/prolapse Prominent urethral meatus Recurrent UTI Absent rugae Fragile/fissured tissue Petechial hemorrhages Scant vaginal secretions Poor elasticity
