menopause Flashcards
avegae age of menopause
51
average duration menopause
7 years
when does contracpetion need to be used in menopause
12 months after last period if 50+ // 24 months after last period if under 50 // <40 continue
diagnosis premature ovarian failure
raised FSH 2 weeks apart
what causes menopause
loss of follicles –> reduced oestrogen –> reduced endometrial proliferation –> amenorrhoea
what type of oestrogen rises and falls in menopause
E2 from ovaries and follicles fall // E1 from adipose and adrenals rises
symptoms menopause
amenorrhoea // vasomotor - hot flushes, night sweats // vaginal dryness // urinary frequency // short term memory loss (brain fog) // depression
long term complications menopause
osteoporosis, IHD
lifestyle mx menopause
exercise (early in the day), weight loss, sleep hygiene
contraindications to HRT
current or past breast cancer // oestrogen sensitive cancer // undiagnosed vaginal bleeding // untreated endometrial hyerplasia
who can receive oestrogen only HRT
women w/o uterus (with uterus = combined)
serious risks HRT
VTE (oral HRT) // stroke (oestrogen only) // coronary heatr disease (combined HRT) // breast cancer (combined HRT) //endometrial cancer (oestrogen)
vasomotor mx for menopause
fluoxetine, citalopram, venlaxafine
vaginal dryness mx for menopause
vaginal lubricant
vaginal atrophy mx for menopause
vaginal oestrogens
stopping HRT
stopping gradually helps limit reoccurence in short term // does not affect long term symptoms
in premature menopause when is HRT indicated until
50 - protect bone health
type of HRT in women at risk of VTE
transdermal patch
SE HRT
nausea, breast tenderness, fluid retention and weight gain
what HRT increases risk of breast cancer
with progesterone // longer use = higher risk // declines once HRT is stopped
what HRT increases risk of endometrial cancer
oestrogen alone in women without uterus // give progesterone continuously
what type of HRT increases risk of VTE
HRT with progesterone
HRT and migraines
safe - may exacerbate migraines
