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Reproductive > Menopause > Flashcards

Menopause Flashcards

1
Q

Menopause

A
  • one year without menses

- FSH > 30

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2
Q

Perimenopause

A
  • age group near menopausal age, 54-55

- with symptoms - menopausal transition

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3
Q

Postmenopause

A

-beyond menopause or age > 55

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4
Q

End of reproductive life is?

A

43

  • ovary continues to produce eggs sporadically, but they are abnormal
  • with ovulation, estrogen is still being produced, but in lower amounts
  • less estrogen produced, FSH rises
  • menses becomes less frequent, lighter
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5
Q

Symptoms of Menopause

A
  • most common: hot flashes
  • probably due to gonadotropin spikes as much as estrogen deficiency
  • may occur as a perimenopausal symptom
  • skin changes/vasodilation have been documented
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6
Q

Menopause at Night

A
  • wake up with sweats, then cooling effect
  • may happen 5 times a night
  • sleep disturbance
  • if no treatment, will dissipate
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7
Q

FDA-Approved Indications for HT

A

-Estrogen: estradiol (pill, transdermal patch, gel)
conjugated estrogens (premarin)
-Progestin added (if has a uterus to prevent endometrial cancer)
medroxyprogesterone (side effects)
micronized progesterone
-treatment of moderate-to-severe vasomotor symptoms associated with menopause

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8
Q

Hormone Therapy in Women with Vaginal Symptoms Only

A
  • dryness or dyspareunia
  • preferred treatments are low doses of vaginal estrogen
  • no need for progestins
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9
Q

Hormone Therapy in Women with a Uterus

A
  • women who still have a uterus need to take a progestogen (progesterone or a similar product) along with the estrogen to prevent cancer of the uterus
  • women with hysterectomy can take estrogen alone
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10
Q

Other Symptoms of Menopause

A

-vaginal atrophy: late effect, but can be treated with estrogens, vaginal or systemic

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11
Q

Symptoms not associated with menopause?

A
  • depression
  • lack of interest in sex
  • going crazy
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12
Q

Medical Illnesses Associated with Menopause

A
  1. Osteoporosis
  2. Heart Disease
  3. Cancer
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13
Q

Osteoporosis: High Risk Groups

A
  • caucasian/asian
  • thin
  • smoker
  • alcohol use
  • steroid use
  • family history
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14
Q

Estrogen Therapy Approved for Prevention of Osteoporosis Not Treatment

A
  • individual risk factors
    screening: bone density measurements beginning at age 65
  • have another indication for hormone therapy
  • affects osteoclast and osteoblast activity
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15
Q

Loss of endogenous estrogen is associated with?

A

CVD

  • oopherectomy & premature ovarian failure
  • women are protected from CVD until menopause (compared to men)
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16
Q

Endogenous estrogen does what?

A

-increases smooth muscle proliferation, lowers cholesterol and improves vascular tone

17
Q

History of CVD

A
  • women aged 35 yrs: fatty streaks & minimal atherosclerotic plaques
  • 45-55: active progression of lesions (menopausal transition)
  • 5-8 post menopause, increased in plaques & intima-media thickening
  • > 65: complications start to develop: Women’s rate equal to mens
  • statins & ASA may not have benefit in women as they do in men*
18
Q

Perimenopausal Use of Hormone Therapy

A
  • positive effects on vascular remodeling of age
  • decreased intimal thickening
  • decreases the incidence of plaques
19
Q

Postmenopausal Use of Hormone Therapy

A
  • women >65
  • plaques already formed
  • estrogen with its thrombogenic effects, clots off the artery
  • effect was in the first year of use: MIs in year 1
20
Q

Hormone Therapy & Coronary Heart Disease

A
  • ET/EPT is not recommended as single or primary indication for coronary protection in women of any age
  • data do not support EPT in secondary prevention of CHD
21
Q

Estrogen Does What?

A

-increased risk of DVT in women 50-59 (no increased risk of stroke for ET or EPT)
women 60-69: increased risk of stroke for ET

-estrogen decreased risk of colon cancer

22
Q

Estrogen & Breast Cancer

A
  • increases with use beyond 5 years
  • it may be progestin that adds risk (small risk)
  • risk decreases after hormone therapy is stopped

Reproductive (14 decks)

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