Exam 4: Menopause

Question 1

Menopause

Answer 1

Permanent cessation of menses for at least one year

Occurs between age 40-55, average age: 51

Cervical exam shows atrophy

Question 2

Physical symptoms of menopause

Answer 2

Hot flashes (vasomotor symptoms VMS)
Fatigue
Vaginal dryness, itchiness
Loss of subQ fat in labia
Insomina
Urinary tract changes
New onset of migraines
Symptoms of arthritis, fibromyalgia
Heart palpitations, atypical angina
Decreased metabolic rate, weight gain

Question 3

Emotional symptoms of menopause

Answer 3

Moodiness
Depression
Memory problems
Fuzzy thinking
Lack of concentration
Greater impatience
Anxiety, restlessness

Question 4

Normal changes of aging

Answer 4

Decreased estrogen effects: Thinning of vaginal walls
Decreased or delayed lubrication
Decreased fat “pad” over symphysis
Labia become less full/atrophy

Treatment: Water-based lubricant, alternative positions for intercourse

Increased predisposition to UTI: Cranberry extract, adequate fluid intake, empty bladder after intercourse

Question 5

Complementary therapies

Answer 5

Diet rich in estrogen (apples, carrots, celery, nuts, wheat, whole grains)
Soy products
Foods rich in boron (asparagus, beans, broccoli, cabbage, prunes, strawberries, tomatoes)
Rhubarb extract
Meditation, stress management, tai chi

Question 6

Bleeding 1 year after menses has stopped

Answer 6

Abnormal

Question 7

Hormone replacement therapy (HRT)

Answer 7

Estrogen/progestin if no hysterectomy
Estrogen if hysterectomy

Monitor signs of: DVT, PE, SOB, breast masses (increased risk for breast cancer = annual mammogram)

Question 8

Medications for menopause

Answer 8

May have spotting with 25 day regimen, if using estrogen patches still need progestin to oppose

Vaginal lubricants

Antidepressants Low dose venlafaxine for hot flashes

Vitamins B6 and E