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Year Three - Reproductive System > Menopause > Flashcards

Menopause Flashcards

1
Q

What is menopause?

A

It is defined as a permanent end to menstruation

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2
Q

What is the clinical definition of menopause?

A

It can be diagnosed once a woman has had no periods for 12 months

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3
Q

On average, when does menopause tend to occur?

A

51 years old

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4
Q

What is perimenopause?

A

It is defined as the time around menopause, where the woman may be experiencing menopausal symptoms and irregular periods

This includes the time leading up to the last menstrual period, and the 12 months afterwards

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5
Q

What is premature menopause?

A

Menopause < 40 Years Old

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6
Q

What is the cause of premature menopause?

A

Premature ovarian insufficiency

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7
Q

Describe the physiology of menopause

A

Menopause begins with a decline in the development of the ovarian follicles, which thus reduces the production of oestrogen

Oestrogen has a negative feedback effect on the pituitary gland, suppressing the quantity of LH and FSH produced

Due to reduced oestrogen levels in the perimenopausal period, there is an absence of negative feedback on the pituitary gland and increasing levels of FSH and LH

The failing follicular development means ovulation doesn’t occur, resulting in irregular menstrual cycles

In addition to this, the endometrium does not develop, leading to a lack of menstruation

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8
Q

What are the seven clinical features of perimenopause?

A

Irregular Periods

Hot Flushes

Night Sweats

Vaginal Dryness

Low Libido

Joint Pains

Mood Changes

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9
Q

What is the physiological cause of perimenopausal clinical features?

A

Decreased oestrogen levels

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10
Q

In most cases, how is menopause diagnosed?

A

Clinical history

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11
Q

What clinical history is sufficient for a diagnosis of menopause to be obtained?

A

It can be diagnosed in women over the age of 45 presenting with perimenopause symptoms and absence of a menstrual period for more than 12 months

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12
Q

What investigation can be used to diagnose menopause?

A

Blood Tests

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13
Q

When are blood tests used to diagnose menopause?

A

In women under the age of 45 with suspected menopause

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14
Q

What two blood test results indicate menopause?

A

Increased FSH & LH Levels

Decreased Oestrogen Levels

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15
Q

What are the four pharmacological management options of perimenopausal?

A

Hormone Repalcement Therapy (HRT)

Antidepressants

Vaginal Lubricants

Vaginal Oestrogen Cream

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16
Q

What is hormone replacement therapy (HRT)?

A

It is defined as medication which replaces female hormones, specifically oestrogen and progesterone

17
Q

What are the five administration forms of hormone replacement therapy?

A

Vaginal Pessary

Vaginal Ring

Vaginal Cream

Oral

Transdermal Patch

18
Q

Why is it recommended that individuals recieve combined hormone replacement therapy?

A

This is due to the fact that oestrogen alone increases the risk of endometrial hyperplasia and endometrial cancer

19
Q

In which circumstance can oestrogen only hormone repalcement therapy be used to treat menopause? Explain

A

When individuals have undergone a hysterectomy

This is due to the fact that there is no endometrium present

20
Q

What are the two hormone replacement therapy regimes?

A

Cyclical

Continous

21
Q

When is the cyclical hormone replacement therapy regime used to manage menopause?

A

When individuals are premenopausal and have not yet reached menopause

22
Q

What is the cyclical hormone replacement therapy reigme?

A

It involves administration of daily oestrogen, alongside progesterone

However, there is progesterone break - enabling a withdrawal bleed

23
Q

When is the continous hormone replacement therapy regime used to manage menopause?

A

When individuals have reached menopause

24
Q

What is the continous hormone replacement therapy reigme?

A

It invovles daily administration of oestrogen and progesterone

25
Q

What are the five risks associated with systemic hormone replacement therapy?

A

Cardiovascular Disease

Stroke

Venous Thromboembolism

Breast Cancer

Ovarian Cancer

26
Q

What are the four contraindications of systemic hormone replacement therapy?

A

Active/Previous Breast Cancer

Oestrogen Sensitive Cancer

Undiagnosed Vaginal Bleeding

Untreated Endometrial Hyperplasia

27
Q

What should be administered when systemic hormone replacement therapy is contraindicated due to the risk of venous thromboembolism?

A

Transdermal hormone repalcement therapy

28
Q

In women who take hormone repalcement therapy for premature menopause, how long should it be adminsitered for? Explain

A

Until > 50

This is due to the fact that it prevents osteoporosis development

29
Q

When are antidepressants used to manage menopause?

A

When individuals experience vasomotor clincial features of perimenopause

30
Q

Name three antidepressants used to manage menopause

A

Fluoxetine

Citalopram

Venlafaxine

31
Q

When are vaginal lubricants used to manage menopause?

A

When individuals experience vaginal dryness clinical features of perimenopause

32
Q

When is vaginal oestrogen cream used to manage menopause?

A

When individuals experience urogenital atrophy clinical features of perimenopause

33
Q

How long should women > 50 years old use contraception after their last period?

A

12 months

34
Q

How long should women < 50 years old use contraception after their last period?

A

24 months

35
Q

Which contraception method is recommended in perimenopausal women?

A

Intrauterine System

36
Q

In women who have the intrauterine system in situ, which is the msot appropriate additional treatment used to manage menopause?

A

Estradiol

37
Q

What are the four complications of menopause?

A

Osteoporosis

Pelvic Organ Prolapse

Urinary Incontinence

Cardiovascular Disease

Year Three - Reproductive System (52 decks)

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