Menopause Flashcards
What is menopause?
The permanent cessation of menstruation
What is menopause due to?
The loss of follicular activity
What happens to the ovaries during menopause?
They begin to fail causing oestradiol levels to fall
What is the clinical diagnosis of menopause?
When a woman hasn’t had a period for 12 months
What is perimenopause?
Get menopause symptoms 3-5 years before menopause while still menstruating
What is premature menopause?
Last ever period at 40 years or younger
What happens to the FSH levels during menopause?
The level of FSH rises
What is the symptomatic period before menopause called?
The climacteric period
What are the symptoms in the climacteric period due to?
Ovarian function starting to fail
When is it recommended to use effective contraception in women over 50?
12 months after their last period
When is it recommended to use effective contraception in women younger than 50?
24 months after their last period
How long do symptoms of menopause usually last?
7 years
What are the symptoms in the climacteric period due to?
Reduced levels of hormones specially oestrogen
What period changes are there in the climacteric period?
Change in length of menstrual cycle
Dysfunctional uterine bleeding
What vasomotor symptoms occur in the climacteric period?
Hot flushes
Night sweats
What sexual dysfunction occurs during menopause?
Vaginal dryness and atrophy
Urinary frequency
Reduced libido
What psychological symptoms can occur during the climacteric period?
Anxiety
Depression
Mood swings
What are long term complications of menopause?
Osteoporosis
Increased risk of ischaemic heart disease
How does menopause cause osteoporosis?
Changes in oestrogen cause a decrease in bone density
What are the 3 categories of treatment for menopause?
Lifestyle modifications
Hormone replacement therapy (HRT)
Non-hormone replacement therapy
What are some lifestyle modifications in the management of hot flushes?
Regular exercise
Weight loss
Reduce stress
How can sleep disturbance be managed?
Avoid late evening exercise
Maintain good sleep hygiene
How can mood be managed in menopause?
Sleep
Regular exercise
Relaxation
How can cognitive symptoms be managed in menopause?
Regular exercise
Good sleep hygiene
What are the 2 forms of hormone replacement?
Oestrogen
Progesterone
What is oestrogen used for?
To overcome oestrogen deficiency
What is progesterone used for?
Endometrial protection
When is combined HRT given cyclically?
In peri-menopausal women who are still menstruating
When is combined HRT given continuously?
In post-menopausal women who aren’t having menstrual periods
What are the benefits of HRT?
Relief of vasomotor symptoms
Relief of urogenital symptoms
Reduced risk of osteoporosis
What are contraindications of HRT?
Current or past breast cancer
Any oestrogen-sensitive cancer
Undiagnosed vaginal bleeding
Untreated endometrial hyperplasia
What are the risks of using HRT?
Venous thromboembolism Stroke Coronary heart disease Breast cancer Ovarian cancer
How are vasomotor symptoms managed?
Fluoxetine
Citalopram
Venlafaxine
How is vaginal dryness managed?
Vaginal lubricant or moisturiser
How are psychological symptoms managed?
Self-help groups
Cognitive behaviour therapy
Antidepressants
What is the management of urogenital atrophy?
Vaginal oestrogen
How is osteoporosis diagnosed?
DEXA scan
How is osteoporosis managed?
Bisphosphonates
How is it advised a patient stops HRT?
By gradually reducing it
