Menopause Flashcards
Transition form normal ovulatory cycles to menopause because of progressive ovarian failure
Menopausal Transition (Perimenopause)
Hallmark of Perimenopause
Skipped periods or longer intervals (40-60 days)
Hormone levels (Perimenopause)
INCREASED FSH
DECREASED INHIBIN
12 mos of amenorrhea after the FMP in the absence of any other pathologic or physiologic causes
Menopause
48-52 (average - 51)
PE in Menopause
decrease in breast size and change in texture
increases in abdominal
circumference and upper abdominal weight gain
vulvovaginal atrophy (VVA)
increase in the BMI
skin changes – loss of elasticity
hair changes
dry eyes
Endocrinologic marker of menopause
FSH > 40 IU/L
Period of time when a woman passes from a reproductive stage to non-reproductive stage
CLIMACTERIC
perimenopause
menopause
postmenopause
Genital Urinary Syndrome of Menopause (GSM)
VULVOVAGINAL ATROPHY
dryness with itching
discharge
dyspareunia
URINARY SYSTEM CHANGES
incontinence
dysuria
Drug Therapy for Menopause
HORMONAL
Estrogens +/- Progestins
Low dose estrogens +/- Progestins
Tibolone
LNG-IUS
Risk Factors for Osteoporosis
SHATTERED
Steroid use (>5 mg/d of Prednisone)
Hyperthyroidism/
Hyperparathyroidism/
Hypercalciuria
Alcohol (>3/d) and tobacco (active or passive) use
Thin (BMI <22, weight 127 lbs)
Testosterone low, hypogonadism
Early menopause
Renal or liver failure
Erosive/ Inflammatory Bone Disease
Dietary Ca low/ Malabsorption of DM type I
Family history/ Genetics
Bone Mineral Density (BMD) screening should begin at age
65 years old
Gold standard in the diagnosis of osteoporosis
Dual energy X ray Absorptiometry (DXA) of lumbar spine and hip
Diagnostic Interpretation:
Normal - T scores >-1
Low bone mass (osteopenia) - T scores <1.0 - >-2.5
Osteoporosis T - scores <-2.5
Medications for prevention of Osteoporosis
Bisphosphonates
Zoledronic acid
Raloxifene
MHT
Treatment for Osteoporosis
Bisphosphonates SERMS Denosumab Calcitonin PTH
