Menopause

Question 1

Contraception in >50 menopause

Answer 1

12 months after the last period

Question 2

Contraception in women <50 years

Answer 2

24 months after the last period

Question 3

Hot flushes mx

Answer 3

egular exercise, weight loss and reduce stress

Question 4

Sleep disturbance

Answer 4

avoiding late evening exercise and maintaining good sleep hygiene

Question 5

Mood

Answer 5

sleep, regular exercise and relaxation

Question 6

Cognitive symptoms

Answer 6

regular exercise and good sleep hygiene

Question 7

Contraindications for HRT

Answer 7

Current or past breast cancer
Any oestrogen-sensitive cancer
Undiagnosed vaginal bleeding
Untreated endometrial hyperplasia

Question 8

How long does treatment of menopause last for

Answer 8

2-5 years on average

Question 9

Risk of HRT

Answer 9

Split into cardiovascular and malignancy

Venous thromboembolism: a slight increase in risk with all forms of oral HRT. No increased risk with transdermal HRT.
Stroke: slightly increased risk with oral oestrogen HRT.
Coronary heart disease: combined HRT may be associated with a slight increase in risk.
Breast cancer: there is an increased risk with all combined HRT although the risk of dying from breast cancer is not raised.
Ovarian cancer: increased risk with all HRT.

Question 10

Which form of HRT provides no risk of VTE

Answer 10

Transdermal

Question 11

Non-HRT management of Vasomotor symptoms

Answer 11

fluoxetine, citalopram or venlafaxine

Question 12

Vaginal dryness

Answer 12

vaginal lubricant or moisturiser

Question 13

Psychological symptoms

Answer 13

self-help groups, cognitive behaviour therapy or antidepressants