Menopause

Question 1

management of Bartholin’s cysts?

Answer 1

broad spectrum antibiotics
incision and drainage
word catheter and marsupialisation if recurrent

Question 2

define menopause

Answer 2

no periods for >12 months

Question 3

what is perimenopause?

Answer 3

irregular periods

Question 4

average age of women entering menopause?

Answer 4

51

Question 5

early menopause age

Answer 5

40-44

Question 6

how long do symptoms of menopause last?

Answer 6

7 years

Question 7

presentation of menopause

Answer 7

• GU problems e.g. dry vagina, painful sex, urinary symptoms
• Mood swings, night sweats, hot flushes
• Dry skin, acne, dry hair, tiredness

Question 8

diagnosis of menopause (treat patients not levels)

Answer 8

• FSH levels x 2 (6 weeks apart) indicated if atypical symptoms, 40-45
• Check FSH, E2, TFTs, glucose, prolactin and FAI in women <40.

Question 9

what does high FSH indicate?

Answer 9

low ovarian reserve

Question 10

management of menopause

Answer 10

• Lifestyle= diet, BMI, exercise, sleep, smoking, alcohol, stress, cool environment
• Alternative therapy e.g. antidepressants, acupuncture, hypnotherapy, herbal
• HRT
• Vaginal oestrogen (moisturisers or lubricant form)

Question 11

adverse of HRT

Answer 11

breast and endometrial cancer
VTE
CVD

Question 12

what age is HRT given in?

Answer 12

40-51

Question 13

alternative to HRT

Answer 13

CHC

Question 14

what preparation of HRT has lower risk of VTE?

Answer 14

transdermal

Question 15

does HRT allow conception

Answer 15

yes

Question 16

HRT if hysterectomy?

Answer 16

only needs oestrogen

Question 17

psychosexual problems

Answer 17

vaginismus
ED
post-TOP
chronic pelvic pain
recurrent discharge
contraception-related problems

Question 18

management of psychosexual problems

Answer 18

perineal massage
lubricants
vibrator

Question 19

presentation of atrophic vulvovaginitis

Answer 19

itch
dryness
soreness
thin discharge
atrophy of labia

Question 20

management of atrophic vaginitis

Answer 20

vaginal oestrogen

Question 21

what is chronic pelvic pain syndrome?

Answer 21

constant or intermittent pain in the lower abdomen or pelvis for at least 6 months