Menopause

Question 1

most common symptoms of perimenopause?

Answer 1

abnormal bleeding, hot flashes, mood changes, sleep disturbance, bone density loss begins

Question 2

treatment of perimenopausal bleeding?

Answer 2

• Low dose OCPs
• cyclic progestins- i.e provera 10mg per day for 10-14 days each month
• IUD
• DepoProvera

Question 3

symptoms of menopause?

Answer 3

• headache and hot flashes
• teeth loosen and gums recede
• risk of cardiovascular disease
• backaches
• breasts droop and flatten

Question 4

what are possible triggers of vasomotor episode?

Answer 4

increasing LH, ACTH, Gh and cortisol

Question 5

how does menopause increase cardiovascular health risks?

Answer 5

• decreased lean mass, increase in cardiac and central adiposity
• vascular remodeling
• menopause causes increase in LDL and triglycerides with decrease in HDL

Question 6

risks associated with hormone therapy?

Answer 6

endometrial cancer
* risk with unopposed estrogen use in women with intact uterus
* always administer progesterone or estrognen andtagonist to protect endometrium

thromobembolism
breast cancer
cardiovascular risk

Question 7

which symptoms should you treat with HT?

Answer 7

Vasomotor symptoms (hot flashes)
genitourinary syndrom of menopause (atrophic vaginitis)

Question 8

when should you not treat with HT?

Answer 8

sleep difficulties (that aren’t VMS related)
mood disordrs
cognitive difficulties
low libido alone
low physical function
prevention of cardiovascular disease
***low bone mineral density

Question 9

what is the window of opportunity?

Answer 9

• generally acceptable to consider HT in women <10 years since onset of menopause or <60 years old
• the risks associated with HT are significantly greater when started >10 years after onset of menopause
• heart disease, VTE, stroke, dementia