Menopause

Question 1

What is menopause?

Answer 1

The permanent cessation of menstruation

Question 2

What is menopause due to?

Answer 2

The loss of follicular activity

Question 3

What happens to the ovaries during menopause?

Answer 3

They begin to fail causing oestradiol levels to fall

Question 4

What is the clinical diagnosis of menopause?

Answer 4

When a woman hasn’t had a period for 12 months

Question 5

What is perimenopause?

Answer 5

Get menopause symptoms 3-5 years before menopause while still menstruating

Question 6

What is premature menopause?

Answer 6

Last ever period at 40 years or younger

Question 7

What happens to the FSH levels during menopause?

Answer 7

The level of FSH rises

Question 8

What is the symptomatic period before menopause called?

Answer 8

The climacteric period

Question 9

What are the symptoms in the climacteric period due to?

Answer 9

Ovarian function starting to fail

Question 10

When is it recommended to use effective contraception in women over 50?

Answer 10

12 months after their last period

Question 11

When is it recommended to use effective contraception in women younger than 50?

Answer 11

24 months after their last period

Question 12

How long do symptoms of menopause usually last?

Answer 12

7 years

Question 13

What are the symptoms in the climacteric period due to?

Answer 13

Reduced levels of hormones specially oestrogen

Question 14

What period changes are there in the climacteric period?

Answer 14

Change in length of menstrual cycle

Dysfunctional uterine bleeding

Question 15

What vasomotor symptoms occur in the climacteric period?

Answer 15

Hot flushes

Night sweats

Question 16

What sexual dysfunction occurs during menopause?

Answer 16

Vaginal dryness and atrophy
Urinary frequency
Reduced libido

Question 17

What psychological symptoms can occur during the climacteric period?

Answer 17

Anxiety
Depression
Mood swings

Question 18

What are long term complications of menopause?

Answer 18

Osteoporosis

Increased risk of ischaemic heart disease

Question 19

How does menopause cause osteoporosis?

Answer 19

Changes in oestrogen cause a decrease in bone density

Question 20

What are the 3 categories of treatment for menopause?

Answer 20

Lifestyle modifications
Hormone replacement therapy (HRT)
Non-hormone replacement therapy

Question 21

What are some lifestyle modifications in the management of hot flushes?

Answer 21

Regular exercise
Weight loss
Reduce stress

Question 22

How can sleep disturbance be managed?

Answer 22

Avoid late evening exercise

Maintain good sleep hygiene

Question 23

How can mood be managed in menopause?

Answer 23

Sleep
Regular exercise
Relaxation

Question 24

How can cognitive symptoms be managed in menopause?

Answer 24

Regular exercise

Good sleep hygiene

Question 25

What are the 2 forms of hormone replacement?

Answer 25

Oestrogen | Progesterone

Question 26

What is oestrogen used for?

Answer 26

To overcome oestrogen deficiency

Question 27

What is progesterone used for?

Answer 27

Endometrial protection

Question 28

When is combined HRT given cyclically?

Answer 28

In peri-menopausal women who are still menstruating

Question 29

When is combined HRT given continuously?

Answer 29

In post-menopausal women who aren't having menstrual periods

Question 30

What are the benefits of HRT?

Answer 30

Relief of vasomotor symptoms Relief of urogenital symptoms Reduced risk of osteoporosis

Question 31

What are contraindications of HRT?

Answer 31

Current or past breast cancer Any oestrogen-sensitive cancer Undiagnosed vaginal bleeding Untreated endometrial hyperplasia

Question 32

What are the risks of using HRT?

Answer 32

``` Venous thromboembolism Stroke Coronary heart disease Breast cancer Ovarian cancer ```

Question 33

How are vasomotor symptoms managed?

Answer 33

Fluoxetine Citalopram Venlafaxine

Question 34

How is vaginal dryness managed?

Answer 34

Vaginal lubricant or moisturiser

Question 35

How are psychological symptoms managed?

Answer 35

Self-help groups Cognitive behaviour therapy Antidepressants

Question 36

What is the management of urogenital atrophy?

Answer 36

Vaginal oestrogen

Question 37

How is osteoporosis diagnosed?

Answer 37

DEXA scan

Question 38

How is osteoporosis managed?

Answer 38

Bisphosphonates

Question 39

How is it advised a patient stops HRT?

Answer 39

By gradually reducing it