Menopause Flashcards
What is the definition of menopause?
When the last menstrual period was over 12 months ago
What symptoms occur during menopuase?
Decrease in estrogen causes increase in FSH to induce vasomotor symptoms:
-hot flashes
-night sweats
-flushing
Due to decreased estrogen there is:
-vaginal dryness, burning, or painful intercourse
What is the best treatment for vasomotor symptoms?
Estrogen
**can be used in combo with progestin
What is the criteria for using hormone therapy for menopause symptoms?
-must be within 10 years of menopause < 60 years old
-if patient is >60 years and the lowest possible dose is used
- patient does NOT have risk of blood clots
Topical estrogen therapy for vaginal symptoms
Estrace
Estring
Vagifem
Premarin
Systemic estrogen therapy
Estradiol patch (Alora, Climara, Vivell-Dot)
Premarin
BW: endometrial cancer, dementia, VTE risk, breast cancer
CI: pregnancy!!!!!
SE: edema, HTN, HA, weight fain, depression
Warning: increase HDL and TG, lowers LDL!!!!! yay good!!!
Micronizaed progesterone (Prometrium)
may have lower risk of breast cancer and CV risk
Estrogen gel counseling points
-these are systemic
-Divigel = apply to upper thigh
-Elestrin = apply to upper arm
- Estrogel = apply on entire arm wrist to shoulder
Which natural supplements help with menopause?
Dong quai
Black cohosh
evening primrose oil
red clover
Soy
What is non-hormonal option for vasomotor symptoms?
Brisdelle (Paroxetine)
**increases the risk of bleeding!!!!!!
**CYP2D6 inhibitor so will decrease efficacy of tamoxifen
What is a treatment that can be used for dyspareunia?
painful intercourse
Ospemifene - an estrogen agonist/antagonist
NOT for mild symptoms
Testosterone products can be used for hypogonadism in males. What are some counseling points?
Topical: RISK for 2nd exposure in children
CI: breast cancer, prostate cancer, pregnancy, breastfeeding
Warning: worsen BPH
SE: increased appetite, acne, edema, hepatotoxicty, reduced sperm count
gels: apply same time each morning
