E5. Menopause Flashcards
what is amenorrhea?
No menstruation for continuous 12 months
Describe menopause?
-Natural process of aging
Ovaries stop ovulating (loss of oestrogen)
-Irreversible loss of fertility
-Effects women from ages 45-50 years (Ave 51yrs)
-Perimenopause (early stage of menopause)
what are the signs of menopause?
-irregular periods that eventually stop
-no symptoms
-or a range of symptoms
what are the range of symptoms that can happen from menopause?
-Hot flashes/ night sweats*
-Mood swings
-Vaginal dryness (increased risk of infections)
-Memory problems
-Weight gain
-Osteoporosis (loss of bone density)
-Can last from 1-10years (Ave 4years)
*account for 70% of women
other reported symptoms of menopause?
-Stress
-Mood swings
-Severe temperature fluctuations
-Loss of sleep/insomnia
-Depression –given antidepressants
-Anxiety
-Midlife crisis
-Reduced sense of well being
-Women with premenstrual syndrome or post partum depression are at most risk
-Sexual dysfunction
what is induced menopause?
-Surgical removal of ovaries
-Chemotherapy
what is premature menopause?
Women who enter menopause <40years
what is post menopause?
When process is complete and symptoms decline
what complications are linked with menopause if left untreated?
-Heart problems
-Osteoporosis
-Muscle weakness
-Weight gain
-Urinary problems
non clinical management of menopause?
-Do nothing!
-Diet
-Rich in vitamin C and D
-Strength building exercises
-Herbal treatments
-Behavioural therapy
Describe hormone replacement therapy?
-replaces loss of oestrogen and progesterone to return back to normal physiological levels
-improves loss of bone density and beneficial effects on urogenital tract- reduces risk of fractures and infections
what are the two main types of hormone replacement theory?
-Combined HRT (oestrogen and progestogen) – for women who still have their womb
-Oestrogen-only HRT – for women who have had their womb removed in a hysterectomy
There are several ways that oestrogen can be taken, including:
-tablets – which can be taken by mouth
-a patch that you stick on your skin
-an implant – underlocal anaesthetic
-oestrogen gel – which is applied to the skin and absorbed
-oestrogen spray—which is applied to the forearm
what are the common hormones for replacement therapy?
estrogen, progesterone, testosterone
Describe estrogen?
-most commonly prescribed hormone
-normally compounded with progesterone
describe progesterone
-commonly prescribed hormone
-often prescribed alongside estrogen
Describe testosterone
-rarely advised for women
-recommended to combine with estrogen and/ or progesterone
types of hormone replacement therapy?
-implants
-sprays
-vaginal rings and suppositories
-creams and gels
-pills and tablets
-skin patches
types of products offered?
-Oral pill
-Transdermal patch
-Transdermal gel
-Vaginal ring
-Presserries
-Topical gels
how does hormone replacement theory manage vasomotor symptoms linked with menopause?
Menopausal symptoms such as hot flushes and night sweats caused by constriction and dilatation of blood vessels in the skin that can lead to a sudden increase in blood flow to allow heat loss. These symptoms can have a major impact on activities of daily living.
how does hormone replacement theory manage urogenital atrophy linked with menopause?
Urogenital atrophycaused by oestrogen deficiency. This results in multiple symptoms such as vaginal dryness, vaginal irritation, a frequent need to urinate and urinary tract infections.
how does hormone replacement theory manage low mood linked with menopause?
Low moodMild depressive symptoms that impair quality of life but are usually intermittent and often associated with hormonal fluctuations in perimenopause.
what else improves with hormone replacement therapy?
Muscle weakness –improves with HRT
how does hormone replacement theory manage fragility fracture(Osteoporosis) linked with menopause?
Fragility fracture(Osteoporosis) Fractures that result from mechanical forces that would not ordinarily result in fracture (such as a fall from a standing height or less). Reduced bone density is a major risk factor for fragility fractures, which occur most commonly in the spine, hip and wrist.
common side effects of hormone replacement therapy?
-tender breasts
-hairloss
-weight gain
-headaches
uncommon side effects of hormone replacement therapy?
-double vision
-chest pains
-jaundice
-depression
risks linked with hormone replacement therapy?
2002 Ground breaking study showed link with increased risk of breast cancer, blood clots, and endometrial cancer and hyperplasia and stroke, liver disease and vaginal bleeding
Describe the risk of heart disease and stroke (cardiovascular disease) linked to hormone replacement therapy
-Age dependant
Studies show that:
If you start HRT before you’re60 it does not increase your risk of cardiovascular disease.
-HRT tablets (but not patches or gels) slightly raise the risk of stroke
Describe the risk of breast cancer linked to hormone replacement therapy
HRT that contains oestrogen and progestogen may increase breast cancer risk
Describe the risk of blood clots (venous thromboembolism) linked to hormone replacement therapy?
HRT tablets only
Describe the risk of dementia linked to hormone replacement therapy
It is currently unknown whether HRT affects the risk of developing dementia. NICE has recommended more research about this.
