Menopause

Question 1

What should endometrial stripe thickness normally be?

Answer 1

<4 mm

Question 2

How often is bone mineral density/DEXA done while on bisphosphonates?

Answer 2

Every 2 years

Question 3

A patient with intact uterus should not receive what hormone replacement therapy?

Answer 3

Estrogen-only therapy

Question 4

What therapy may actually worsen hot flashes?

Answer 4

Selective estrogen receptor modulator therapy (e.g. Raloxifene)
Raloxifene is an ER agonist (alpha receptor) in bone but antagonist (beta receptor) in uterus and breast

Question 5

How can postmenopausal removal of ovaries result in recurrent menopausal symptoms?

Answer 5

Ovaries still produce androstenedione and testosterone, which can be converted to estrogen in peripheral fat tissue

Question 6

Combination MHT most increases risk of which cancer (and decreases risk of which cancer)?

Answer 6

Breast cancer (apparently estrogen alone does not increase breast cancer risk according to WHI study)

Reduces risk of colon cancer

Question 7

What are the contraindications to combination MHT?

Answer 7

Breast cancer
Coronary heart disease
Prior DVT or stroke
Active liver disease

Question 8

A woman without uterus should receive what menopausal therapy?

Answer 8

Just estrogen through patch - no uterus to worry about endometrial cancer

Progrsterone can slightly increase risk of breast cancer

Question 9

Ovarian hyperthecosis

Answer 9

Virilization typically in postmenopausal women - solid-appearing, enlarged ovaries
Symptoms of insulin resistance
Low/normal LH and FSH