Menopause Flashcards
When is menopause diagnosed
After 12 months amenorrhea
When is the average age for the menopause
51
What is postmenopausal
Period 12 months after amenorrhea onwards
What is the perimenopause
Around menopause when vasomotor symptoms and irregular periods
Includes time leading up to last menstrual period and 12 months afterwards
Normally >45
When is premature menopause and why happens
<40
due to premature ovarian insufficiency
What is menopause caused by
Lack of ovarian follicular function ->
Low oestrogen and progesterone
High LH and FSH (absent negative oestrogen feedback)
Pathophysiology of menopause
Starts with decline in development of ovarian follicles -> reduced production of oestrogen
Lack of supression of FSH and LH in pituitary gland (high oestrogen inhibits release)
Annovulation - irregular cycles
Endometrium doesnt develop in absence of oestrogen - amenorrhea
What causes perimenopausal symptoms
Lack of oestrogen
Perimenopausal symtpoms
Hot flushes
Emotional lability or low mood
Premenstrual syndrome
Irregular periods
Joint pains
Heavier or lighter periods
Vaginal dryness and atrophy
Reduced libido
What conditions increase risk after menopause and why
Lack of oestrogen
CVS disease and stroke
Osteoporosis
Pelvic organ prolapse
Urinary incontinence
Diagnosis of menopause
Clinical if over 45 and typical symptoms
When perfrom FSH blood test to help diagnosis
Women under 40 years w sus premature menopause
40-45 w menopausal symptoms or change in menstrual cycle
How long after last menstrual period do women need to use contraception for?
2 years if under 50
1 year if over 50
Best contraceptive methods for women approaching menopause
Barrier methods
Mirena or copper coil
Progesterone only pill
Progesterone implant
Progesterone depot injection under 45 years
Sterilisation
When is the COCP UKMEC2
after 40, can be used up to 50 years
