Gynae Clinic - HRT and menopause Flashcards
What is the menopause?
How is it diagnosed?
Complete cessation of follicular ovarian activity for 12 consecutive months.
Caused by low oestrogen
It is diagnosed via the history. May be via bloods - High FSH and low oestrogen
What is pre menopause?
Begins with the onset of irregular periods and ends when menopause begins
What is premature ovarian failure?
Menopause before 40
What are the symptoms of menopause?
7 dwarf signs
- Itchy
- Bloaty
- Sweaty
- Sleepy
- Forgetul
- Bloated
- Psycho
When do you treat menopause with HRT?
What are the three options
Vasomotor symptoms are overwhelming
- Continuous oestrogen and progesterone
- Cyclical oestrogen and progesterone
- Oestrogen only
What are the indications for each type of HRT?
Continuous oestrogen and progesterone - Not had period for 12 months
Cyclical oestrogen and progesterone - Still having peripds i.e premenopausal. Oestrogen every day and pogesterone last 12
Oestrogen only - if you have had a a hysterectomy as no risk of unopposed oestrogen causing uterine cancer
What can you give if the main symptom is vaginal dryness?
Topical oestrogen cream
What are the contraindications to HRT?
Previous gynae cancer - Main side effect
DVT/PE
CVD
What cancers does the COCP increase?
BC - Breast and cervical
Lowers the rest
What are the main causes of post menopausal bleeding?
Cervical or endometrial (uterine)
