21. Menopause

Question 1

Menopause

Answer 1

Menstruation ceases permanently due to the loss of ovarian follicular activity. Diagnosed after 12 months of spontaneous amenorrhoea. The average age is 52 years.

Question 2

Perimenopause

Answer 2

The period before the menopause when the endocrinological, biological, and clinical features of approaching menopause commence due to decreasing oestrogen levels; marked by irregularity of Menstrual Cycles.

Question 3

Early menopause

Answer 3

10% of women can have menopause by the age of 45

Question 4

Premature ovarian insufficiency (POI)

Answer 4

Menopause that occurs at an age less than two standard deviations below the mean established for the reference population. In practice, in developed countries, 41 years of age is the cut-off point.

Question 5

Causes of Premature Ovarian Insufficiency:

Answer 5

• Idiopathic
• Chemotherapy
• Radiotherapy
• Ovarian suppression (zoladex)
• Hormone therapy (tamoxifen, letrozole, exemestane)

Question 6

Diagnosis of Premature Ovarian Insufficiency:

Answer 6

• Age <40
• FSH levels >40 IU/ml
• Oestradiol <50 qmol/ml

Question 7

Main mechanisms of Premature Ovarian Insufficiency:

Answer 7

• Dysfunction of follicular maturation

- Depletion in the follicular pool

Question 8

Risks of Premature Ovarian Insufficiency:

Answer 8

• Increased osteoporosis risk
• Cardiovascular disease
• Premature morbidity and mortality
• Dementia
• Depression
• Cognitive decline and parkinsonism

Question 9

Seven witches of menopause:

Answer 9

Itchy, bitchy, sweaty, sleepy, bloated, forgetful, psycho