flashcards_menopause
What diet and lifestyle changes are recommended for managing menopause symptoms?
Stop smoking, reduce alcohol and caffeine consumption, weight loss, stress reduction, regular exercise.
What type of hormonal replacement therapy (HRT) is suitable for women who have had a hysterectomy?
Oestrogens alone, e.g., Elleste Solo.
Why is progestogen necessary when using oestrogen HRT for women with a uterus?
Progestogen is necessary to protect the endometrium.
What are the different regimens for oestrogen with progestogen HRT?
Monthly: oestrogen every day + progesterone for the last 14 days. Three Monthly: oestrogen every day for 3 months + progesterone for the last 14 days. Continuous: oestrogen & progesterone daily.
What routes are available for HRT administration?
Oral, transdermal, vaginal creams/gels.
What are the benefits of HRT?
Improved vasomotor symptoms, sleep, performance, prevention of osteoporosis, improved genital tract symptoms.
What are the risks and side effects associated with HRT?
Breast cancer, cardiovascular disease, VTE. Oestrogenic: breast tenderness, nausea, headaches. Progestogenic: fluid retention, mood swings, depression.
What are the absolute contraindications for HRT?
Pregnancy, breast cancer (current or past), endometrial cancer, uncontrolled hypertension, current VTE, current thrombophilia, undiagnosed vaginal bleeding, severe liver disease.
What non-hormonal treatments are available for managing menopause symptoms?
Alpha agonists (e.g., clonidine), beta-blockers (e.g., propranolol), SSRIs (e.g., fluoxetine), symptomatic treatments (e.g., lubricants, osteoporosis treatments).
What is the role of alpha agonists, beta-blockers, and SSRIs in menopause management?
Alpha agonists and beta-blockers for vasomotor symptoms, SSRIs and CBT for vasomotor symptoms and psychological support.
What are the lifestyle recommendations for managing menopause symptoms?
Regular exercise, weight loss, stress reduction, sleep hygiene.
What are the contraindications for HRT?
Current or past breast cancer, undiagnosed vaginal bleeding, untreated endometrial hyperplasia.
What are the specific HRT recommendations for women with and without a uterus?
No Uterus: oestrogen-only (patch if BMI>30). Uterus: oestrogen with progesterone component (e.g., Mirena).
What non-HRT treatments are available for vasomotor symptoms, vaginal dryness, psychological symptoms, and urogenital symptoms?
Vasomotor: fluoxetine, citalopram, venlafaxine. Vaginal dryness: lubricant. Psychological: self-help, CBT, SSRIs. Urogenital: topical oestrogens, lubricants.
What should be explained to patients about contraception during menopause?
Until > 1 year amenorrhoeic if > 50 years, until > 2 years amenorrhoeic if < 50 years.
