19 - Menopause

Question 1

What does Menopause mean?

Answer 1

The last menstrual period

Question 2

How many menopausal women are there in the UK?

Answer 2

> 12 million

Question 3

What is the average age for menopause?

Answer 3

51-52 years old

Question 4

What is early menopause? What percentage of people have it?

Answer 4

20% of women

Aged 40-45

Question 5

What is premature menopause? What percentage of women have it?

Answer 5

1%

<40 years old

Question 6

What is climetric?

Answer 6

The time leading to menopause
also known as perimenopause
Transitional phase where reproductive function declines and ceases

Question 7

What are the symptoms of climetric?

Answer 7

Changes in length of menstrual cycle

Hot flushes and night sweats

Question 8

When does climetric begin?

Answer 8

Menopause at 50 - a year earlier

Menopause <40 - 4 years earlier

Question 9

What is ovarian failure?

Answer 9

E2 (oestrogen) deficiency

Question 10

What are the short term symptoms of ovarian failure?

Vasomotor, psychological, urogenital and collagen

Answer 10

Vasomotor - hot flushes, night sweats, headaches, palpitations
Psychological - Depression, mood swings, insomnia, panic, memory loss
Urogenital - urinary frequency, stress, vaginal dryness
Collagen - dry, inelastic skin, brittle nails, hair loss, joint/muscle pain

Question 11

What are the long term symptoms of ovarian failure?

CVS, Skeletal, Skin, genito-urinary and psychological

Answer 11

CVS - ischaemic heart disease, hyperlipidaemia
Skeletal - Osteopnia and osteoporosis
Skin - Thin, elastic, flaky
Genito-urinary - depressed libido, atrophic changes, prolapse of uterus, bladder and rectum
Psychological - alzheimers

Question 12

What is osteoporosis?

Answer 12

More reabsorpion of bone than osteogenesis

Reduction in bone mass

Question 13

What is osteoperosis most common in?

Answer 13

White women - 50% have a fracture by age 82

Lowest risk is afro-carribean

Question 14

How do you diagnose menopause?

Answer 14

Typical symptomalogy
12 months amenorrhoea
FSH> 15iu/ml
Bone mineral densitometry

Question 15

Why are Serum oestradiol levels not useful when diagnosing menopause?

Answer 15

There is a wide range of normality?

Question 16

What is the treatment for menopause?

Answer 16

Hormone replacement therapy
If uterus present - oestrogen and progesterone
If uterus absent - oestrogen alone

Question 17

How can HRT be administered?

Answer 17

Oral
Patches, gels
Implancts, injections
Intravaginal creams
Nasal sprays
Routes that avoid mouth - reduce serious complications

Question 18

What are some side effects of HRT?

Answer 18

Heavy cyclic bleeding
Bloating
Fluid retention
Weight gain
Muscle cramps
Headaches
Depression

Question 19

What can be some complications of taking HRT?

Answer 19

Breast cancer

Thrombo-embolic events

Question 20

What are some non-hormonal treatments for menopause?

Answer 20

Biphosphates and calcitonin - decrease osteoclast activity
Selective oestrogen receptor modulators
Clonidine and venlafaxine - reduce vasomotor symptoms