Exam 2 - Menopause

Question 1

Risk factors for early menopause

Answer 1

• Low SES
• Low body weight
• Nulliparity
• Smoking
• No use of OCPs
• History of depression and/or postpartum depression
• PMS/PMDD
• Surgical menopause (before age 48 years)
• Thyroid dysfunction

Question 2

What is the physiological mechanism that causes menopause?

Answer 2

Ovaries become more resistant to FSH –> produce less estrogen, androgen, progesterone –> FSH and LH levels increase (loss of negative feedback from estrogen)

• Estrogen levels drop for 2 years
• Hot flashes likely to occur and last 3-6 years

Question 3

What happens to androgens after menopause?

Answer 3

After menopause, androgens are converted to estrone in adipose tissue

Question 4

What is the relationship between estrogen and body weight?

Answer 4

Body weight contributes to postmenopausal estrogen levels (decreasing weight, decreasing estrogen levels)

Question 5

What are the three main forms of estrogen?

Answer 5

• Estrone (E1) - major circulating estrogen
• Estradiol (E2) - major potent estrogen secreted by dominant follicle and corpus luteum in premenopausal years
• Estriol (E3) - weakest estrogen secreted from placenta and metabolized from estrone

Question 6

When are estrogen levels highest and lowest during a womens lifecycle?

Answer 6

Highest during reproductive years (increasing from follicular phase, mid cycle, luteal phase); lowest during postmenopausal years (drops lower than 37 pg/mL)

Question 7

90% of women experience ___ years of menstrual changes before final menstrual period

Answer 7

4-8 years

Question 8

What is the difference between the early and late transition of menopause?

Answer 8

Early - variable cycle length (>7 days), 10+ consecutive cycles

Late - more than 2 skipped cycles, interval of amenorrhea >60 days, cycles become anovulatory from 1-3 years