Disorders Of The Menopause

Question 1

Can tibolone be given when there’s CVS risk

Answer 1

Need caution since it is a SERM. acts as estrogen in some receptors and anti-estrogen in others

Question 2

What is premature menopause and the diagnostic criteria

Answer 2

Onset of amenorrhea due to follicular insufficiency before the age of 40

• more than 4 months amenorrhea
• FSH levels >40ml IU/ml on at least 2 occasions one month apart
• exclusion of secondary causes of amenorrhea

Question 3

Investigating POI

Answer 3

• reduced AMH
• increased Day 3 FSH and LH
• reduced oestradiol, predominant oestrone
• reduced day 21 (mid luteal) progesterone

Question 4

Managing POI

Answer 4

COCP

• for bone protection and CVD risk reduction
• continue this till the age of 50 (cyclical)