Menopause Flashcards
When does the menopause usually occur?
Between 49-52
How would you define menopause?
No period for over a year in if women is between 49-52
It may also be defined by a decrease in hormone production by the ovaries
What are signs and symptoms of menopause?
Shorter cycles Painful intercourse, vaginal dryness Hot flushes Atrophic vaginitis Lack of energy Irritability Osteoporosis
What is premature ovarian insufficiency?
Partial or complete loss of the reproductive and hormonal function of the ovaries before the age of 40
How common is premature ovarian insufficiency?
Affects:
1/10000 women under 20
1/1000 women under 30
1/100 women under 40
How would you diagnosis premature ovarian insufficiency?
Age less than 40
Medical triad:
- Amenorrhea (more than 4 months)
- High FSH (over 40mlU/ml) at two different times a month apart
- Hypoestrogenism
What are the signs and symptoms of premature ovarian insufficiency?
Similar to menopause, but often less severe
How does premature ovarian insufficiency affect fertility?
Around 5-10% can get pregnant without any medical help
Main means of parenthood is IVF or adoption
How do you treat premature ovarian insufficiency and menopause?
HRT until the age of 51
With vasomotor symptoms, oestradiol + progesterone
For urogenital symptoms, vaginal oestrogen preperation
What are the risks of hormone replacement therapy?
Venous thromboembolism Coronary heart disease Type 2 diabetes Dementia Breast cancer
What are the benefits of hormone replacement therapy?
Decreased fragility fractures
Increased muscle mass and strength
What causes menopause?
The main cause of this transition is the natural depletion and aging of the finite amount of oocytes (ovarian reserve)
What does the depletion of the ovarian reserve cause, hormone-wise?
The depletion of the ovarian reserve causes an increase in circulating follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels because there are fewer oocytes and follicles responding to these hormones and producing estrogen
How do you stage menopause?
The stages of the menopause transition have been classified according to a woman’s reported bleeding pattern, supported by changes in the pituitary follicle-stimulating hormone (FSH) levels
What is the ovarian reserve?
Ovarian reserve is a term that is used to determine the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy
