menopause

Question 1

pathphys

Answer 1

Depletion of ovarian follicles with age –> decline in ovarian function –> estrogen and progesterone levels fall –> loss of negative feedback to gonadotropic hormones –> increased GnRH levels –> increased levels of FSH and LH in blood (hypergonadotropic hypogonadism) –> increased frequency of anovulatory cycles –> ovarian function eventually stops completely

Question 2

Clinical features

Answer 2

Irregular menses –> amenorrhea

Autonomic symptoms: sweating, hot flashes

Mental: impaired sleep, mood swings, loss of libido

Atrophic: breast atrophy, vulvovaginal atrophy (vaginal dryness, pruritis, dyspareunia), urinary atrophy, osteoporosis

HAVOCS (Hot flashes/Heat intolerance, Atrophy of Vagina, Osteoporosis, Coronary artery disease, Sleep impairment)

Question 3

menopause

Answer 3

12 months of amenorrhea

typically occurs between 45-55

Question 4

what is Ospemifene (Osphena)

Answer 4

SERM agonist for vaginal tissue

Question 5

what is Genitourinary Syndrome of Menopause (GSM)

Answer 5

decrease in superficial cells leads to increased mucus membrane sensitivity and dryness

decreased blood flow to vagina

increased pH