Menopause Flashcards
What is the climacteric
Phase of a womans life which marks transition from reproductive to non reproductive phase over a period of 5-10 years
Most visible event of the climateric
menopause- the last menstruation
There is infrequent menses prior due to disordered maturation of ovarian folliicles, cycles are anovulatory
WHAT IS MENOPAUSE
Cessation of menstrual flow for 12 consecutive months
There is an increase in gonadotrophins and fall in estrogen
What happens to the follicles in menopause
reduced response to pituitary gonadotrophins
Impaired folliculogenesis
Menopause causes
induced
natural
Both have same symptoms
what causes natural menopause
depletion of primary oocytes
Range of age of menopause
45-55
Solely genetically predetermined
Premature menopause
Menses stops spontaneously before 40
Causes of premature menopause
chromosomal abnormalities autoimmune dx irradiation, chemotherapy inborn errors of metabolism removal of ovaries/damaged ovaries
why are gonadotrophin levels increased in menopause
Reduced activity of inhibin and loss of negative feedback from oestrogen and progesterone
Oestrone levels
increase and become most prominent estrogen in menopause
estradiol levels
Reduce, though they are the most common estrogen in circulation prior to menopause
Peripheral conversions occur
in adipose tissue and muscle
Progesterone levels in menopause
reduce
Effects of menopause
Hot flushes sweating and palpitation insomnia moodswings anxiety joint pains loss of memory
Effects of menopause on reproductive system
Amenorrhea atrophic changes in reproductive system thinning of vaginal epithelium vaginal bleeding increased vaginal discharge due to reduced defence to bacterial invasion loss of vaginal rugae
Effects of menopause on urinary system
- epithelium of urogenital lining becomes affected
- bladder epithelium easily irritated leading to increased frequency and urgency of micturition
- Stress incontinence puts pressure on bladder
- cystitis
- haematuria
Menopause effect on skin and hair
loss of elasticity and thinning in skin
wrinkling around mouth ( pure string) and eyes (crow feet)
Menopause effect on bone metabolism and osteoporosis
rate of bone loss is accelerated
Psychological effects of menopause
anxiety mood swings sleep disorders dementia irritability depression
Reasons for psychological effects
may be due to low estrogen levels which affect brain neurotransmitters
Depression may be due to co existing chronic illnesses and lack of supportive attitudes to their complains, children leaving home
Effect of menopause on sexual function
Dyspareunia - genital pain during sex
vulvodynia -vulvar redness, edema, contact pain
Impaired sensory input from clitoris causes low libido
Management of menopause
Take good history to identify all symptoms
counselling
diet rich in calcium, vitamin D and protein
exercise
increased Exposure to sunlight
Hormone replacement therapy
Mainstay treatment for menopause
hormone replacement therapy
