Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Menopause > Flashcards

Menopause Flashcards

1
Q

What is menopause?

A

The point in a woman’s life where menstruation stops permanently due to loss of ovarian function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is menopause typically diagnosed?

A

Retrospectively - 12 months of amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is peri-menopause?

A

The period before the menopause characterised by irregular periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is post menopausal?

A

The time after a woman has had no period for 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is early menopause and premature?

A

40-45 years old and <40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What hormonal changes occur during menopause?

A
  1. During peri-menopause - the ovaries begin to fail and oestrogen production decreases
  2. Reduced negative feedback to the pituitary
  3. FSH and LH levels increase
  4. FSH levels fluctuate on a daily basis during this stage
  5. Falling oestrogen levels disrupt the menstrual cycle and cause typical menopausal symptoms
  6. Cycles become anovulatory and follicular development stops
  7. Estradiol levels become too low to stimulate the endometrium and amenorrhea occurs
  8. Final result is high levels of FSH and LH and low levels of oestrogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the symptoms of menopause?

A
  1. Low mood
  2. Low sex drive
  3. Muscle and joint pain
  4. Vaginal dryness
  5. Difficulty concentrating
  6. Hot flushes
  7. Changes to period
  8. Trouble sleeping due to night flushes
  9. Palpitations
  10. Headaches can become worse
  11. Changes in body shape and weight
  12. Dry and itchy skin
  13. Recurrent UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you diagnose menopause?

A

Women over 45 - symptoms alone

Any abnormal bleeding - investigated and underlying pathology ruled out

Women less than 45 - FSH levels are checked providing they aren’t taking combined HC or HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What lifestyle advice would you give for menopause?

A
  1. Regular exercise
  2. Maintain a healthy BMI
  3. Stop smoking
  4. Reduce alcohol consumption
  5. Avoid triggers
  6. Reduce stress
  7. Sleep hygiene
  8. Relaxation exercises
  9. Frequent showers to cool down
  10. Wear layers of clothes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HRT has a beneficial effect on…

A
  1. Sexual function
  2. Urogenitak atrophy
  3. Musculoskeletal symptoms
  4. Bone mineral density

Used for first line treatment of vasomotor symptoms and low mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is transdermal chosen over oral HRT?

A

Used in women women with:

  1. Increased risk of VTE
  2. S/E’s from oral preps
  3. Concomitant use of hepatic enzyme inducing drugs
  4. Malabsorption condition
  5. Lactose sensitivity
  6. History of migraine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the C/I’s for HRT?

A
  1. Current, past or suspected breast cancer
  2. History/active VTE
  3. Oestrogen dependant cancer
  4. Undiagnosed vaginal bleeding
  5. Untreated endometrial hyperplasia
  6. Active liver disease
  7. Pregnancy
  8. Thrombophillic disorder
  9. Active or recent arterial thromboembolic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is unopposed HRT?

A

Oestrogen only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is opposed HRT?

A

Oestrogen and Progestogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who would unopposed be used in?

A

Women who have had a total abdominal hysterectomy or mirena in situ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who would opposed HRT be used in?

A

Women with a uterus to reduce the risk of endometrial hyperplasia or endometrial cancer

Women with a history of endometriosis who have had a hysterectomy

17
Q

How does sequential HRT work?

A

Mimics menstrual cycle and causes a monthly bleed

Oestrogen taken continuously and Progestogen taken for the last 12-14 days of the 28 day cycle

18
Q

How does combined HRT work?

A

Bleed free regimen

Oestrogen and Progestogen are taken together with no break

Recommended in post-menopausal patients 1 year since last period

A lower dose of Progestogen is used

19
Q

What are the risks for HRT?

A
  1. VTE
    - oral greater than transdermal
    - risk with transdermal HRT at standard doses no greater than baseline risk
  2. CHD
    - baseline risk will vary from woman to woman
    - HRT with oestrogen alone no/reduced risk of CHD
    - combined little or no increase risk of CHD
  3. Endometrial cancer
    - reduced by using opposed
  4. Ovarian cancer
    - small increased risk with both HRT
    - risk disappears after a few years of stopping
20
Q

What are the benefits associated with HRT?

A
  1. Fragility fractures
    - risk reduced taking HRT
  2. Colorectal cancer
    - 5-10 years of use halves the risk
21
Q

What is tibilone?

A

Synthetic steroidal compound with oestrogenic, Progestogenic and androgenic activity licensed for the treatment of menopause in post menopausal women

Patients do have a withdrawal bleed

22
Q

What are the risks of tibilone?

A
  1. Stroke
  2. Endometrial cancer
  3. Breast cancer
23
Q

What is the treatment for urogenital symptoms?

A

Low dose oestrogen

Blissel gel - 1 applicator contains 50 micrograms estriol
Vagifem - 10 micrograms vaginal tablets
Ovestin - 0.1% cream 1mg cream
Estring - replaced every 3 months max 2 years

24
Q

How do you treat vasomotor symptoms?

A
  • fluoxetine OD
  • citalopram 20mg OD
  • paroxetine 10mg OD
  • venlafaxine 37.5mg for one week then 75mg if tolerated
  • clonidine 50 micrograms bd for two weeks then increased to 75 bd if needed
  • gabapenin 300mg tds
25
Q

How do you treat urogenital symptoms?

A
  • ky jelly for sec
  • vaginal moisturisers such as replens MB
  • used in conjunction with vaginal oestrogen
26
Q

What are alternative therapies to HRT for symptomatic relief?

A

Isoflavones and black cohosh may relieve vasomotor symptoms but the quality, purity, constituents and safety may be unknown and diff preps may vary

27
Q

How often should women be reviewed?

A

Every 3 months after starting/changing HRT then annually

28
Q

What should you review?

A

Efficacy and tolerability, side effects, monitor BP and weight

Ensure she doesn’t need to transition from sequi to conti

Enquire ab unscheduled bleeding

Pharmacology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions