Menopause Flashcards
average age
51
what is the contraception advice in terms of how long?
12 months after the last period in women > 50 years
24 months after the last period in women < 50 years
Mx (x3)
Lifestyle modifications
Hormone replacement therapy (HRT)
Non-hormone replacement therapy
Mx life style
hot flushes - exercise, weight loss and reduced stress
sleep - avoid late evening exercise and maintain good sleep hygiene
mood - sleep, reg exercise and relax
cognitive - reg exercise and sleep
contraindications to hrt
Current or past breast cancer
Any oestrogen-sensitive cancer
Undiagnosed vaginal bleeding
Untreated endometrial hyperplasia
what form of hrt can be given
oral or transdermal patch
how long can symptoms menopause last for
2-5 years
risk of hrt
VTE
Stroke
CHD
Breast Ca
Ovarian Ca
management of vasomotor symptoms non-hrt
fluoxetine, citalopram or venlafaxine
vaginal dryness management
Vaginal lubricant or moisturiser
psychological symptoms
self-help groups, cognitive behaviour therapy or antidepressants
urogenital symptoms
urogenital atrophy vaginal oestrogen - if they are not taking hrt this is appropriate
stopping treatment
For vasomotor symptoms, 2-5 years of HRT may be required with regular attempts made to discontinue treatment. Vaginal oestrogen may be required long term. When stopping HRT it is important to tell women that gradually reducing HRT is effective at limiting recurrence only in the short term. In the long term, there is no difference in symptom control.
stopping treatment
For vasomotor symptoms, 2-5 years of HRT may be required with regular attempts made to discontinue treatment. Vaginal oestrogen may be required long term. When stopping HRT it is important to tell women that gradually reducing HRT is effective at limiting recurrence only in the short term. In the long term, there is no difference in symptom control.
when should you refer to secondary care
She should be referred to secondary care if treatment has been ineffective, if there are ongoing side effects or if there is unexplained bleeding.
