Climacteric and Menopause - The Menopause Flashcards
What is the Menopause?
A retrospective diagnosis made after a woman has had no period for 12 months - a permanent end to menstruation.
Average Age of Menopause.
51 Years.
What is Postmenopause?
The period from 12 months after the final menstrual period onwards.
What is Perimenopause?
The time around menopause - the woman may experience vasomotor symptoms and irregular periods (time leading up to the last menstrual period and the 12 months after it).
What is Premature Menopause?
Menopause before the age of 40 - result of premature ovarian insufficiency.
Hormones of Menopause.
Lack of Ovarian Follicular Function resulting in :
- Low Oestrogen and Progesterone Levels.
- High LH and FSH levels (in response to low Oestrogen).
Aetiology of Menopause.
Decline in the development of ovarian follicles causing reduced production of Oestrogen.
What does Menopause cause in terms of Menstrual Cycles?
- Anovulation.
- Irregular Menstrual Cycles.
- Amenorrhoea.
What causes Perimenopausal symptoms?
Low levels of Oestrogen.
What conditions can the Menopause predispose an older woman to? (4)
Lack of Oestrogen :
- Cardiovascular Disease/Stroke.
- Osteoporosis.
- Pelvic Organ Prolapse.
- Urinary Incontinence.
Perimenopausal Symptoms (8).
- Hot Flushes.
- Emotional Lability/Low Mood.
- Premenstrual Syndrome.
- Irregular Periods.
- Joint Pains.
- Heavier/Lighter Periods.
- Vaginal Dryness/Atrophy.
- Reduced Libido.
Diagnosis of Menopause (2).
- Clinical - above 45 with typical symptoms (no investigations).
- FSH Blood Test : under 40 and suspected Premature Menopause or 40-45 and Menopausal Symptoms.
Management of Vasomotor Symptoms (3).
- Fluoxetine.
- Citalopram.
- Venlafaxine.
Management of Perimenopausal Symptoms.
- Conservative.
- HRT (? Tibolone).
- Clonidine.
- CBT.
- SSRIs.
- Gel/Cream Testosterone.
- Vaginal Oestrogen.
- Vaginal Moisturisers.
What is Clonidine?
An a-adrenoceptor agonist and Imidazoline Receptor Agonist.
