Menopause Flashcards
What is the average age of menopause in the UK?
52 years old
What does Climateric mean?
Stage of life when woman gradually loses cyclical ovarian activity due to declining number of ovarian primordial follicles
How does menopause occur in terms of loss of ovarian function?
During reproductive years, ovulation and follicle atresia causes decreased numbers and quality and when a critical level is reached, ovulation stops
How is menopause diagnosed in over 45s?
Clinical history, age and symptoms
What additional investigations may be needed in those presenting with menopause before 45 years old?
FSH level
Consider genetic testing
Give 5 symptoms of menopause
- Vasomotor: hot flushes and night sweats
- Vulvo-vaginal dryness
- Sleep disturbance
- Mood disturbance
- Sexual dysfunction
Which form of oestrogen is usually used in HRT?
17beta-Oestradiol
Give 3 preparations of oestrogen in HRT
Oral (1-2mg/day)
Transdermal patch
Pessary
What usually needs to be given in addition to oestrogen in HRT and why?
Progestin for endometrial cover
Define the pathology of osteoporosis in menopause
Decline in oestrogen allows osteoclasts to live longer, increasing bone turnover
How is the use of HRT relevant to the risk of of CVD?
Reduced death from CVD but increased risk of stroke
What is the breast cancer risk associated with HRT?
No increase in risk with estradiol alone but small increase in estradiol and progestin combined
What is the risk of VTE when using HRT?
Increased risk with oral HRT but not transdermal
Give 3 pharmacological alternatives to HRT for vasomotor symptoms
Gabapentin
Clonidine
SSRI
