Lecture 9 - Menopause Flashcards
Menopause
Permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity
Ovaries can no longer produce follicles - oestrogen decreases
Definition of menopause
No menstruation periods for 12 consecutive months and no other biological or physiological cause identified
Early menopause
Menopause occurring before 45
Premature menopause (pathological)
Cessation of menopause as all ovarian follicles depleted before 40
(Premature ovarian failure)
Menopausal transition
Time between onset of irregular menses and permanent cessation of menstruation
Average - 4 years
Climacteric
Physiological period in a woman’s life during which there is regression of ovarian function
What age does ovarian function decline
45 - 55 years old
Average - 50yrs old
Stages of menopause
Premenopause
Perimenopause
Menopause
Post menopause
Premenopause
Time before menopause
- less oestrogen secretion
- Reduced fertility
- cycle relatively unchanged
Perimenopause (climacteric)
Transitional phase Physiological changes: - mood swings - hot flushes - infrequent menstruation
Follicular phase shortens and ovulation is early or absent
Post menopause
Time after a women has experience amenorrhoea for over 12 months
No longer able to conceive
Oestrogen decrease
Once oestrogen decreases past a critical level can no longer inhibit FSH and LH
Hormone measured to diagnose physiological menopause
FSH - increases significantly
Symptoms of menopause
Itchy - puritis Twitchy - restless limbs Sweaty Sleepy Bloated Moody Forgetful
Early signs of menopause
Hot flushes Sweating Insomnia Irregular menstruation Mood swings Depression
Intermediate menopause symptoms
Vaginal atrophy Dyspareunia Skin atrophy - breasts Urge stress continence Frequent UTIs - atrophy of urethra and bladder lining Reduced pubic hair
Late menopause symptoms
Osteoporosis - increased osteoclasts activity
Atherosclerosis - CHD, CVD - increased cholesterol and less HDLs
Dysfunctional uterine bleeding
- spotting between cycles
- menorrhagia
Changes in oestrogen:
- increased risk of carcinoma as unopposed aromatisation of androgens
- endometrial thickening as no progesterone
Psychological changes
Mood swings Fatigue Irritability Depression Insomnia Frequent headaches
Genital changes
Atrophy of ovaries
Uterus atrophy
Vaginal atrophy
Breast atrophy
Loss of pubic hair and smaller labia majora
Changes in general appearance
Skin - loses elasticity
Weight - increased - change in food habits
Hair - dry, coarse and hair loss
Voice - deeper due to thickening of vocal cords
Digestive changes
Decrease gut motility
Urinary changes
Urinary incontinence
Frequent UTIs
Hormone replacement therapy
Oestrogen
- pill
- vaginal cream
- transdermally - patch
