menopause

Question 1

menopause is associated with

Answer 1

1. hot flushes
2. brain fog
3. increased cardiovascular risk
4. increased risk of fracture/osteoporosis
5. genitourinary syndrome of menopause

Question 2

cause of hot flushes

Answer 2

• mPOA received info from skin & viscera and compares to body temp for homeostasis
• some have ORalpha
• kisspeptin neurons in hypothalamus produce LH pulses that project to mPOA via neurokinin B. loss of oestrogen receptors > unstable activity

Question 3

cause of brain fog

Answer 3

• prefrontal cortex (working memory) and hippocampus have ORalpha and beta
• morphological changes in synaptic connections restored if you add cyclic oestrogen

Question 4

why menopause > cardiovascular risk

Answer 4

• oestrogen stimulates prostacyclin, NO, eNOS, COX1, PGIS, ACR
• decreased proliferation of smooth muscle and vascular relaxation

Question 5

why is timing for HRT important

Answer 5

ERalpha dominant early, ERbeta dominant late

Question 6

why greater risk of fractures with menopause

Answer 6

oestrogen can
- suppress production of inflammatory cytokines which stimulate osteoclasts
- decrease RANKL expression
- increase Bcl2 > less apoptosis of osteoblasts
- decrease sclerostin expression which promotes resorption

Question 7

why does genitourinary syndrome of menopause occur

Answer 7

maybe because bladder and genitals have common embryological origin

Question 8

drug that decreases osteoclast activity through RANKL

Answer 8

denosumab

Question 9

drug that inhibits sclerostin

Answer 9

romozosumab