Lecture 5

Question 1

What did the WHI institute find with use of HRT

Answer 1

study was stopped early because HRT was found to increase risk of breast cancer by about 25% and also appeared to increase heart disease, stroke and pulmonary embolism

Question 2

compared with placebo, estrogen + progestin resulted in

Answer 2

• increased risk of stroke
• increased risk of blood clots
• increased risk of breast cancer
• reduced risk of colorectal cancer
• fewer fx
• increased risk of dementia

Question 3

when does menopause usually occur

Answer 3

one year after the last mentrual period

-avg is 51.5yold

Question 4

What is artificial induction of menopause

Answer 4

hysterctomy and removal of fallopian tubes

• radiation therapy
• causes more sudden and severe symptoms

Question 5

What is the theory of menopause hormonally

Answer 5

• Inhibin starts the process of hormonal imbalance
• Inhibin controls FSH by neg feedback
• As inhibit decreases FSH increases
• this causes several follicles being stimed leading to increased estrogen

Question 6

Early changes in perimenopause and what are estrogen lvls like

Answer 6

Early- breast tenderness, bloating, heavier bleeding, mood swings, cycles get closer
–High estrogen

Question 7

Later changes of perimenopaunse and estrogen lvls

Answer 7

Cycle is less frequent and start getting hot flashes and night sweats
–estrogen declines

Question 8

what is the phases of menopause, when does it start and sympatomolohy

Answer 8

• refers to a time period when women notice changes usually starting in 40s
• breast tenderness, mood swings,, shorter cycles, heavy mentruation, night flashes, weight gain etc

Question 9

process of perimenopause in relation to progesterone

Answer 9

progesterone levels begin to drop faster then estrogen

• estrogen lvls erratic]
• imbalance of progesterone and estrogen is through to lead to symptoms of perimenopause

Question 10

What commonly happens to women during perimenopause

Answer 10

women in perimenopause may become accidentaly preg (commonly w twins as ovaries reaease multiple eggs)

Question 11

signs of decreasing estrogen

Answer 11

• cervix decreases in size and mucous
• uterus is smaller and atrophic
• ovaries decrease in size
• vaginal walls are thinner, atrophic, drier etc
• more prone to inf
• bladder may become atrophic and cause urinary incontinence
• fibroids
• osteoperosis

Question 12

What is the mc symptom of perimenopause

Answer 12

Hot flushes/flashes (75-80%)

• Sudden intense feeling of heat starting in face
• nigt sweats/insomia

Question 13

mc herbs that helps with menopause

Answer 13

Black cohosh

gamma oryzanol
chaste tree berry
valerian
st johns wort
motherwort

Question 14

what is the common medical tx of perimenopause

Answer 14

premarin

(conjugated equine estrogen combined with synthetic progestin

Question 15

Dr. Priors three reasons to start HRT

Answer 15

1. early menopause <40 or <45 with hot flashes
2. Chronic and disturbing hot flashes/night sweats that affect quality of life
3. Osteoperosis