Case 4 - perimenopausal synrdome

Question 1

Objective

Answer 1

Clinical presentation of Perimenopausal state
How to comfirm your diagnosis
Replacement therapy
Any risk for continuous estrogen progestin replacement therapy

Question 2

Any test for the perimenopausal syndrome?

Answer 2

Low estrogen concentration, elevated serum FSH & LH levels.
Symptoms like Irregular menses, vasomotor changes, hot flushes, vaginal dryness, episodes of warmth and sweating, bone loss due to estradiol level falls.

Question 3

Treatment for perimenopausal syndrome and hot flushes

Answer 3

Estrogen replacement therapy with progestin (hot thrushes)

Question 4

Age of
1.Early menopausal
2.Mean age menopausal
3.Premature ovarian failure

Answer 4

< 45
51

< 40

Question 5

What kind of disease should be considered if cessation of ovarian function due
to atresia of follicles < 30 years

Answer 5

autoimmune diseases or karyotypic abnormalities

Question 6

Risk of continous Estrogen-progestin treatment

Benefits of the treatment

Answer 6

breast cancer, heart disease, pulmonary
embolism, and stroke

Fewer fractures & lower incidence of colon cancer
** But short term (<6 months) therapy had no evidence of adverse effect.

Question 7

Therapy other than Estrogen-progestin treatment

Answer 7

the antihypertensive agent clonidine may help with the vasomotor symptoms.
A selective estrogen receptor modulator (SERM), such as raloxifene, is helpful in preventing bone loss, but does not alter the hot flushes.

Question 8

Test for Osteoporosis and osteopenia

Answer 8

Bone mineral density (BMD) testing, such as by dual-energy x-ray absorptiometry
(DEXA)

Question 9

Bone mineral density (BMD) testing is offering for what age patient or what kind of patient

Answer 9

> 65 and alcohol abuse people