FAM MED S5 OSCE - MENOPAUSE

Question 1

Menopause symptoms (8)

Answer 1

• Irregular periods
• Hot flushes
• Vaginal dryness
• Low libido
• Low mood / mood swings
• Tiredness
• Difficulty concentrating
• Insomnia

Question 2

Explain menopause (3)

Answer 2

• Menopause has occurred when a woman has not had a period for 12 months
• There are changes to your body’s hormone levels (such as estrogen and progesterone)
• Ovaries stop maturing eggs and thus you can no longer have children

Question 3

Enquire about patient context (3 areas)

Answer 3

• Impact of symptoms on life and wellbeing
• Use of any medications/therapies to alleviate symptoms
• Observations of other family members that have experienced menopause

Question 4

Menopause treatment starter

Answer 4

Identify therapeutic goals
- Short term goals: symptom relief?
- Long term goals: preventing onset of symptoms?

Menopausal symptoms can be managed with HRT or with non-HRT options

Question 5

Non-HRT options (6)

Answer 5

• CBT
• Antidepressants
• Sleeping pills for insomnia
• Analgesics for pain
• Estrogen cream
• Dressing in layers (hot flushes)
• Complementary therapies (dietary changes, aromatherapy)

Question 6

HRT indications

Answer 6

• Short term relief of menopause symptoms
• <5 yrs

Question 7

Tests/examinations to do before commencing HRT (3)

Answer 7

• Breast examination
• Cervical screening
• Mammography

Question 8

Contraindications for HRT (6)

Answer 8

• Oestrogen dependent tumour
• Current/past/suspected breast cancer
• Family history of breast cancer
• Thrombophilia
• Venous thromboembolism
• Liver disease
• Coronary heart disease

Question 9

Safety netting - menopause and treatment

Answer 9

• Offer educational material (pamphlet) on HRT and non-HRT options
• Support group for women undergoing menopause
• I am available to answer any of your questions
• Anything else?