Menopause

Question 1

what is the average age of menopause in the UK?

Answer 1

51 years old

Question 2

when is contraception recommended in menopausal women?

Answer 2

• 12 months after last period if < 50 years
• 24 months after last period if > 50 years

Question 3

what is the definition of menopause?

Answer 3

permanent cessation of menstruation
amenorrhoeic for 12 months

Question 4

how long do menopausal symptoms typically last?

Answer 4

7 years

Question 5

what vasomotor symptoms can you experience in menopause?

Answer 5

• hot flushes
• night sweats

Question 6

what urogenital symptoms can you experience in menopause?

Answer 6

• vaginal dryness and atrophy
• urinary frequency

Question 7

what psychological symptoms can you experience in menopause?

Answer 7

• anxiety and depression
• short-term memory impairment

Question 8

what long-term complications can you experience in menopause?

Answer 8

• osteoporosis
• increased risk of ischaemic heart disease

Question 9

what lifestyle modifications can be used to help hot flushes?

Answer 9

• regular exercise
• weight loss
• reduce stress

Question 10

what lifestyle modifications can be used to help sleep disturbance?

Answer 10

• avoiding late evening exercise
• maintaining good sleep hygiene

Question 11

what lifestyle modifications can be used to help mood?

Answer 11

• sleep
• regular exercise
• relaxation

Question 12

what lifestyle modifications can be used to help cognitive symptoms?

Answer 12

• regular exercise
• good sleep hygiene

Question 13

what are the contraindications for HRT?

Answer 13

• current or past breast cancer
• any oestrogen-sensitive cancer
• undiagnosed vaginal bleeding
• untreated endometrial hyperplasia

Question 14

what increases the risk of endometrial cancer development in menopausal women?

Answer 14

unopposed oestrogen in a women with a uterus

Question 15

what are the risks of HRT?

Answer 15

• venous thromboembolism
• stroke
• coronary heart disease
• breast cancer
• ovarian cancer

Question 16

how can the increased risk of venous thromboembolism be decreased in women taking HRT?

Answer 16

no increased risk with transdermal HRT

Question 17

non-HRT management

how can vasomotor symptoms be managed?

Answer 17

• fluoxetine
• citalopram
• venlafaxine

Question 18

non-HRT management

how can vaginal dryness be managed?

Answer 18

vaginal lubricant or moisturiser

Question 19

non-HRT management

how can psychological symptoms be managed?

Answer 19

• self-help groups
• cognitive behaviour therapy
• antidepressants

Question 20

non-HRT management

how can urogenital symptoms be managed?

Answer 20

• vaginal oestrogen
• moisturisers and lubricants

Question 21

who receives sequential (cyclical) HRT treatment?

Answer 21

• perimenopausal women
• LMP <1 year ago

Question 22

who receives continuous HRT treatment?

Answer 22

• postmenopausal women
• LMP >1 year ago

Question 23

how can unopposed oestrogen be avoided?

Answer 23

mirena coil

Question 24

what advise should you give women wanting to stop HRT?

Answer 24

gradually reduce HRT to avoid recurrence