Menopause Flashcards
What is peri menopause?
The time period from the first instance of climatic symptom caused by fluctuating hormonal levels to one year after menopause
Length is 4 years
What is premenopause
The time period from the first accurance or climacteric irregular menstruation cycles to the last menstrual period
During 45-55 years
Increasing infrequent menstruation
Menopause
No menstruation + confirmed after 1 year of amenorrhea in the absence of contraceptives
Pathophysiology
1) decrease ovarian follicles
2) decrease of ovarian function
3) decrease estrogen and progesterone
4) negative feedback
5) increase GnRH
6) increase FSH & LH
7) increase Anovulatory cycles
8) ovarian function stops
Clinical features
- complete amenorrhea
- sweating , hot flashes , heat intolenrence , headache
- insomnia
- mood swings
- anxiety
- breast tissue atrophy
- vuvlovaginal atrophy
- urinary atrophy
- osteoporosis
Coronary artery disease
Diagnosis
- above 45
Lab - decrease estrogen , progesterone
- increase FSH , increase cholesterol
—- oral contraception can mask the sign and symptoms —-
Treatment for hot flashes
Avoid triggers ( bright light )
Use fans
Treatment for vaginal dryness
Vaginal estrogen creams
treatment for osteoporosis ?
- cut smoking
- vit D
- regular excercise
treatment is hormone replacement therapy
Estrogen therapy ( hysterectomy )
Estrogen + progestin ( breast cancer )
Non HT
- selective estrogen receptor modulators
( tamoxifen , aspemifene )
What do we do for postmenopausal bleeding ?
Endometrial biopsy
Causes for postmenopausal bleeding ?
- cervical or endometrial cancer
- endometriosis
- endometrial hyperplashia
- endometrial polyps
- uterine leiomyomas
- hormonal replacement therapy
- atrophic vaginitis
