Menopause

Question 1

Define pre, peri and postmenopause

Answer 1

Premenopause - regular periods
Perimenopause - irregular periods
Postmenopause - no periods >12 months

Question 2

What is the average age of menopause in the UK?

Answer 2

51 years old

Question 3

What is classed as early menopause?

Answer 3

40-44 years old

Question 4

What is classed as Premature Ovarian Insufficiency?

Answer 4

Menopause <40 years old

Question 5

On average how long do menopause symptoms last?

Answer 5

7 years

Question 6

Name the menopause symptoms

Answer 6

Mood swings, night sweats, hot flushes, weight gain, fatigue, sexual problems, UTI, dry skin/hair, memory loss, aches/pains

Question 7

What happens to FSH in perimenopause?

Answer 7

Fluctuates

Question 8

What are the indications for measuring FSH?

Answer 8

• women >50 on hormonal contraception who want to stop
• > 45 with atypical symptoms
• 40-44 years old with menopausal symptoms/iatrogenic amenorrhoea

Question 9

How are FSH tests conducted?

Answer 9

2 tests 6 weeks apart

Question 10

When would E2, TFT, prolactin and FAI be measured in addition to FSH?

Answer 10

<40 years old

<35 years old and chromosomal/autoimmune condition

Question 11

Describe the lifestyle advice for menopause

Answer 11

Healthy diet, weight management, exercise, good sleep hygiene, no smoking, limited alcohol/caffeine, reduce stress, CBT

Question 12

What environmental factors can help with menopause symptoms?

Answer 12

Ventilation, temperature, suitable clothes, fans, cooling spray

Question 13

State some non-hormonal therapies that can help with menopause

Answer 13

Herbal - st john’s wort
Complementary - homeopathy, hypnotherapy
Non-hormonal - antidepressant
Fanny magnet

Question 14

What are the benefits of HRT?

Answer 14

Symptomatic relief 
Increased quality of life 
Better mental health 
Better sexual health 
Reduced risk of osteoporosis 
Reduced CVD until 60 years old 
Prevents and treats atrophy

Question 15

What are the risks of HRT?

Answer 15

Increased risk of breast cancer
Increased VTE risk
Increased CVD risk over 60 years old

Question 16

State the contraindications to HRT

Answer 16

History of breast cancer 
Coronary heart disease 
TIA/Stroke 
Unexplained bleeding 
Active liver disease

Question 17

Name the different types of HRT

Answer 17

Oral, gel, patch, spray, transdermal

Question 18

How is endometrial dysplasia prevented?

Answer 18

Progesterone is given to women without a hysterectomy/mirena

Question 19

What should be given to all women with early menopause?

Answer 19

HRT and continue contraception

Question 20

In women aged 40-49 when should contraception be stopped?

Answer 20

2 years after amenorrhoea

2 years after 2 FSH results >30

Question 21

In women >50 when should contraception be stopped?

Answer 21

1 year after last period

1 year after FSH >30

Question 22

At what age can contraception be stopped?

Answer 22

> 55

Question 23

What treats vulvo-vaginal atrophy?

Answer 23

Topical oestrogen

Moisturisers and lubricants