Menopause

Question 1

What is menopause

Answer 1

Permanent cessation of mentruation due to loss of ovarian hormone production

Question 2

What is perimenopause?

Answer 2

Transition period between optimal menstruation and menopause.
Fewer oocytes -> infrequent ovulation
Vasomotor symptoms of reduced estrogen are seen - hot flushes & vaginal atrophy.

Question 3

Symptoms of perimenopause?

Answer 3

Abnormal uterine bleeding
endometrial neoplasia (increased estrogen(increased FSH)
Hot Flushes
Headaches

Question 4

Treatment of perimenopause?

Answer 4

Progesterone

Hormone replacement therapy

Question 5

Causes of early menopause? (under 40 years)

Answer 5

Smokers
Past ovarian surgeries
chemotherapy/pelvic radiation
chromosomal abnormalities

Question 6

Physiology of menopause?

Answer 6

Fewer Oocytes
FSH receptors absent
Estradiol and inhibin too low to reduce FSH levels
Ovarian stromal cells now produce androgens (instead of follicle)

Question 7

Symptoms of menopause?

Answer 7

Vaginal atrophy - smaller vagina, dryer - dyspareunia
Vasomotor symptoms - hot flashes and night sweats
Osteoporosis (fractures) and Increased risk of CVD

Question 8

Treatment of Menopause?

Answer 8

HT - Combined oral contraceptive pills. Reduces symptoms of hypoestrogenism.
ET - Estrogen therapy

Question 9

Risks of HT?

Answer 9

Endometrial cancer 
Abnormal bleeding
Venous thromboembolism (stroke, PTE)