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Reproductive System > Menopause > Flashcards

Menopause Flashcards

1
Q

Define menopause

A

Permanent cessation of menstruation caused by failure of ovarian follicular development and oestrogen production

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2
Q

What age is classified as early menopause?/

A

Under 45 years old

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3
Q

What age is classified as premature menopause?

A

Under 40 years old

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4
Q

What is surgical menopause/

A

Permanent cessation of menstruation after bilateral oophorectomy

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5
Q

What is premature menopause?

A

Cessation of menstruation due to depletion of ovarian follicles before age of 40 (premature ovarian failure)

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6
Q

What is perimenopuase?

A

Physiological period in a women’s life before menopause when there is a regression of ovarian function

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7
Q

What is the average age for menopause?

A

51

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8
Q

What are the 4 phases of menopause?

A
  • pre-menopause
  • peri-menopause
  • menopause
  • post menopause
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9
Q

Outline pre-menopause

A
  • slightly less oestrogen secreted
  • LH + FSH levels may rise
  • reduced fertility
  • cycles are relatively unchanged
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10
Q

Outline peri-menopause

A
  • transition phase/climacteric
  • follicular phase shortens
  • early or absent ovulation (changes to cycle)
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11
Q

When does menopause occur?

A

When ovaries are totally depleted of follicles + no amount of stimulation from gonadotropins can force them to work

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12
Q

How do you diagnose menopause?

A

Diagnose without lab tests in healthy women over 45 years old with:
- peri-menopause: irregular periods, vasomotor symptoms
- menopuase: no period for >12 months + no using hormonal contraception

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13
Q

Who can you use FSH tests to diagnose menopause on?

A
  • women 40-45 years with menopausal symptoms
  • women under 40 years when menopause in suspected
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14
Q

When should you not use FSH tests to diagnose menopause?

A

In women using combined oestrogen + progesterone contraception or high dose progesterone

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15
Q

Early symptoms of menopause

A
  • hot flushes
  • sweating
  • insomnia
  • irregular periods
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16
Q

Intermediate symptoms of menopuase

A
  • vaginal atrophy
  • dysparenunia
  • skin atrophy
  • urge-stress incontinence
17
Q

Late symptoms of menopuase

A
  • osteoporosis
  • atherosclerosis
  • coronary heart disease
  • cardiovascular disease
  • Alzheimer’s

Due to lack of protective effect of periods + oestrogen

18
Q

What are the changes that occur to the menstrual pattern during menopause?

A
  • intermenstrual bleeding
  • Menorrhagia
  • mid-cycle bleeding
  • itregular cycles
19
Q

How does changes in oestrogen cause changes in menstrual pattern in menopause?

A
  • hyperplasia of endometrium (thickening)
  • this causes late menstrual period the irregular bleeding + spotting
  • no corpus luteum due to no progesterone
  • increased rick of carcinoma
20
Q

What psychological changes can occur during menopause?

A
  • irritability
  • confusion
  • lethargy
  • memory loss
  • loss of libido
  • brain fog
21
Q

What changes to appearance can occur during menopause?
- skin
- weight
- hair
- voice

A
  • skin loses elasticity + becomes thin due to loss of elastin + collagen
  • increased weight due to irregular food habits as a result of mood changes
  • more deposition of fat around hips, waist + buttock
  • hair becomes dry + coarse
  • possible hair loss
  • voice deepens as vocal cords thicken
22
Q

Menopausal effects on the urinary system

A

Tissue lining urethra + bladder becomes thinner + less elastic:
- loss of pelvic tone
- urinary incontinence
- reduced elasticity of bladder > frequency, urgency + nocturia
- increased risk of UTI

23
Q

Menopausal effects of GI tract

A

Decreased motor activity of entire digestive tract > constipation

24
Q

Menopausal changes in genital organs
How are these changes treated?

A

Due to lack of oestrogen:
- thinning of vaginal skin > superficial dyspareunia + bleeding
- lack of glycogen > increase in vaginal pH > increased risk of infection
.
Topical oestrogen

25
Q

Menopausal changes to the breast

A
  • low oestrogen levels decrease fat + tissue in breast
  • mammary gland tissue shrinks
  • breasts sag as connective tissues lose elasticity
26
Q

Menopausal bone changes

A
  • calcium loss
  • reduced oestrogen enhances osteoclast ability to absorb bone
  • risk of osteoporosis + fragility fractures
27
Q

Conservative management of menopause

A
  • regular exercise
  • avoid triggers
  • sleep hygiene
  • keep hydrated + eat healthy
  • need for contraception until periods stopped
28
Q

Benefits of hormone replacement therapy for menopause

A
  • reduced vasomotor symptoms
  • improvement in mood changes
  • improvement in urogenital symptoms
  • reduced osteoporosis risk
  • reduced risk of colorectal cancer
29
Q

Treatment of vasomotor or mood changes in menopause

A

Oral or transdermal HRT
- Combined oestrogen + progesterone if with uterus
- oestrogen only is no uterus

30
Q

Risks of hormone replacement therapy
What type increases risk?

A
  • Venous thromboembolism: oral
  • Coronary heart disease: no increased risk if start before 60 years old
  • Stroke: tablets
  • Breast cancer: combined oestrogen + progesterone
  • Endometrial cancer: oestrogen only
31
Q

Advantages and disadvantages of oral HRT

A

advantages:
- cheap
- effective
.
disadvantages:
- first pass metabolism
- variable plasma levels
- higher dose needed

32
Q

Advantages and disadvantages of transdermal HRT (patch/gel)

A

advantages:
- avoids first pass metabolism
- reduced risk of VTE
- continuous administration
.
disadvantages:
- cost
- skin reactions

33
Q

Advantages and disadvantages of vaginal HRT

A

advantages:
- good for urogenital symptoms
- minimal systemic absorption
.
disadvantages:
- unlikely to treat other symptoms

34
Q

Advantages and disadvantages of mirena intrauterine system HRT (progesterone coil)

A

**advantages*:
- lasts for 4 years to provide progesterone
.
disadvantages:
- only provides progesterone for endometrial protections
- patients still need oestrogen another way

Reproductive System (20 decks)

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