4.4.1 Menopause

Question 1

What can help reduce the risk for VTE due to ERT?

Answer 1

Route of admission.

Transdermal reduces risk as compared to oral

Question 2

What can reduce the risk for osteoporosis?

Answer 2

BMI under 30, current estrogen use, alcohol use (>14 drinks/wk), former estrogen use, regular exercise

Question 3

What do the T and Z scores measure?

Answer 3

Both measure bone density. T score is compared to young adults. Z score is compared to people of same age, sex, and race.

Question 4

What is the best way to treat hot flashes?

Answer 4

Estrogen replacement therapy (takes 2-3 wks to kick in)

Question 5

What are some of the different hormone replacements of estrogen?

Answer 5

Question 7

What occur in 75% of menopause patients often causing them to seek medical attention?

Answer 7

Hot flashes

Question 8

How does estrogen affect various components of atherosclerosis?

Answer 8

Estrogen reduces atherosclerosis

Estrogen has adverse effects on established plaques and CHD

Question 9

What can lead to irregular bleeding?

Answer 9

Anovulatory cycles

Question 10

What is menopause?

Answer 10

Permanent cessation of menstruation due to the loss of ovarian follicular activity

Question 11

What are the stages of a hot flash?

Answer 11

Normal temp

Slightly elevated temp

Quite elevated temp

Sub-nomral temp

Question 12

How does ERT/HRT effect lipids?

Answer 12

HDL: increase

LDL: decrease

Triglycerides: increased

Question 13

What are some risk factors for osteoporosis?

Answer 13

Current cortisone use, current and former smoking, maternal history of fracture

Question 14

What are some ways to treat/modulate hot flashes of menopause?

Answer 14

Question 15

What are some of the various ways that the GU atrophies during/after menopause?

Answer 15

Epithelial thinning

Decreased vaginal lubrication

Decreased blood flow

Increased susceptibilty to infection

Question 16

What racial group is at most risk for hot flashes? Least risk?

Answer 16

Most: AA

Least: Chinese/Japense

Question 17

How is age of menopause changing as life expectancy is increasing?

Answer 17

Question 18

What are some ways to manage osteoporosis?

Answer 18

Question 19

What happens to FSH levels after menopause?

Answer 19

Rise above 30

Question 20

What are some potential medical conditions that occur as a result of unopposed estrogen?

Answer 20

Endometrial hyperplasia and carcinoma

Question 21

What are the 7 dwarfs of menopause?

Answer 21

Itchy, bitchy, sweaty, bloaty, sleepy, forgetful, psycho

Question 22

What happens to estrogen, progesterone and androgen levels after menopause? Why?

Answer 22

All decrease b/c of ovarian follicular depletion

Question 23

What are some of the hormone replacements for progestins?

Answer 23

Question 24

What is the ACOG recommendation for ERT?

Answer 24

Lowest effective dose for the shortest duration

Question 25

What are some indicators/possible causes of premature ovarian failure?

Answer 25

Question 26

What % of women experience menopause prior to age 40?

Answer 26

1%

Question 27

Which gender is better at surviving bone fractures?

Answer 27

Women

Question 28

How should estrogen be replaced in pre-menopausal (reproductive year) woman? post-menopausal?

Answer 28

Reproductive: Estradiol

Menopausal: Estrone

Question 29

What is peri-menstruation?

Answer 29

Period of waning ovarian function. Time from onset of menopausal symptoms to one year after the final menstrual period

Question 30

What sexual conditions are increased as a result of menopause (decreased estrogen)?

Answer 30

Vaginal dryness, Dyspareunia (frequency/intensity), Pain w/ penetration, Burning

Question 31

Whats the difference b/t cohorts and cohort studies?

Answer 31

Question 32

What happens to bone loss over time in women?

Answer 32

Menopause causes a period of increased bone loss

Question 33

What are the various symptoms that occur as estrogen declines?

Answer 33