Exam 2 - Menopause: diagnosis and management

Question 1

How would a provider diagnose menopause?

Answer 1

No single test used to predict or confirm menopause - based on menstrual and medical history

Question 2

Why can’t providers monitor lab levels to diagnose menopause?

Answer 2

Offer little information since levels of progesterone, FSH, and LH are erratic during perimenopause

Question 3

In what special circumstances can the provider use labs to monitor estrogen and progesterone levels?

Answer 3

• Estrogen levels considered for patients with persistent vasomotor symptoms without hormone therapy
• Progesterone levels to document ovulation in perimenopausal women who want to conceive

Question 4

Menopause differential diagnoses

Answer 4

• Diabetes
• Thyroid disorders
• Depression
• Carcinoma
• HTN
• Arrhythmias
• Anemia
• Pregnancy

Question 5

Nonhormonal lifestyle changes for menopause management

Answer 5

• Avoid triggers for hot flashes - maintain symptom diary
• Maintain cool environment, sleep with a fan
• Relaxation techniques
• Reduce caffeine intake before bed (e.g. alcohol, energy drinks, smoking)
  
  • Can take 7 hours for caffeine to clear from system
• Don’t eat heavy meals before bed

Question 6

How would the provider advise a patient with vaginal dryness to treat it?

Answer 6

• Patient can use lubricants and moisturizer (e.g. coconut oil, olive oil, vitamin E oil)
• Avoid antihistamines, douching, soaps/colored or perfumed toilet tissue
• Humidifier adds moisture to air
• Increase fluid intake

Question 7

What prescriptions can be given to women with vaginal dryness during menopause?

Answer 7

Reserved for women who have not responsed to lifestyle changes or who can’t use hormone therapy

• SSRIs/SNRIs
• Anticonvulsants
• Antihypertensives