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Reproductive Module > Menopause > Flashcards

Menopause Flashcards

1
Q

What is the climacteric

A

Phase of a womans life which marks transition from reproductive to non reproductive phase over a period of 5-10 years

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2
Q

Most visible event of the climateric

A

menopause- the last menstruation

There is infrequent menses prior due to disordered maturation of ovarian folliicles, cycles are anovulatory

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3
Q

WHAT IS MENOPAUSE

A

Cessation of menstrual flow for 12 consecutive months

There is an increase in gonadotrophins and fall in estrogen

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4
Q

What happens to the follicles in menopause

A

reduced response to pituitary gonadotrophins

Impaired folliculogenesis

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5
Q

Menopause causes

A

induced

natural

Both have same symptoms

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6
Q

what causes natural menopause

A

depletion of primary oocytes

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7
Q

Range of age of menopause

A

45-55

Solely genetically predetermined

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8
Q

Premature menopause

A

Menses stops spontaneously before 40

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9
Q

Causes of premature menopause

A 
chromosomal abnormalities
autoimmune dx
irradiation, chemotherapy
inborn errors of metabolism
removal of ovaries/damaged ovaries
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10
Q

why are gonadotrophin levels increased in menopause

A

Reduced activity of inhibin and loss of negative feedback from oestrogen and progesterone

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11
Q

Oestrone levels

A

increase and become most prominent estrogen in menopause

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12
Q

estradiol levels

A

Reduce, though they are the most common estrogen in circulation prior to menopause

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13
Q

Peripheral conversions occur

A

in adipose tissue and muscle

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14
Q

Progesterone levels in menopause

A

reduce

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15
Q

Effects of menopause

A 
Hot flushes
sweating and palpitation
insomnia
moodswings
anxiety
joint pains
loss of memory
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16
Q

Effects of menopause on reproductive system

A 
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
17
Q

Effects of menopause on urinary system

A
  • 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
18
Q

Menopause effect on skin and hair

A

loss of elasticity and thinning in skin

wrinkling around mouth ( pure string) and eyes (crow feet)

19
Q

Menopause effect on bone metabolism and osteoporosis

A

rate of bone loss is accelerated

20
Q

Psychological effects of menopause

A 
anxiety
mood swings
sleep disorders
dementia
irritability
depression
21
Q

Reasons for psychological effects

A

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

22
Q

Effect of menopause on sexual function

A

Dyspareunia - genital pain during sex
vulvodynia -vulvar redness, edema, contact pain
Impaired sensory input from clitoris causes low libido

23
Q

Management of menopause

A

Take good history to identify all symptoms
counselling
diet rich in calcium, vitamin D and protein
exercise
increased Exposure to sunlight
Hormone replacement therapy

24
Q

Mainstay treatment for menopause

A

hormone replacement therapy

25
Q

Hormone replacement therapy is

A

the use of estrogen/estrogen and progesterone combination as treatment

26
Q

Main goals of HRT

A

to prevent osteoporosis
relief of menopausal symptoms
good quality life

27
Q

Risk of HRT

A

Endometrial hyperplasia
cancers
deep vein thrombosis

28
Q

Precautions in administering HRT

A

Give lowest effective dose
usage should not exceed 5 years
HRT should be stopped once symptoms are relieved
estrogen only for women who have undergone hysterectomy
0.3-0.625 mg of conjugated equine is sufficient daily

29
Q

Non oral HRT routes

A 
Vaginal estrogen rings
vaginal tablets and creams
transdermal patches
sub dermal patches
Levonorgestrel intrauterine system

Reproductive Module (4 decks)

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