Menopause Flashcards
Menopause can be defined by which of the following?
1 - symptoms associated with menopause such as brain fog and hot flushes beyond >45 y/o
2 - no menstrual cycle beyond >45 y/o
3 - no menstrual cycle for >12 months whilst not using contraception
4 - all of the above
3 - no menstrual cycle for >12 months whilst not using contraception
Essentially causes a drop in oestrogen
What is the mean age that menopause occurs?
1 - 40
2 - 45
3 - 48
4 - 51
4 - 51
- typically occurs between 45-55 y/o
Premature menopause typically occurs in those under what age?
1 - 40
2 - 45
3 - 48
4 - 51
1 - 40
- can be caused by a myriad of reasons, including chemotherapy and surgery
Menopause is defined as having no menstrual cycle for >12 months whilst whilst not using contraception. What is the definition of peri-menopause, also called premature ovarian insufficiency?
1 - symptoms associated with menopause such as brain fog and hot flushes beyond >45 y/o
2 - no menstrual cycle beyond >45 y/o
3 - symptoms associated with menopause such as brain fog and hot flushes alongside irregular menstrual cycles and bleeding
4 - all of the above
3 - symptoms associated with menopause such as brain fog and hot flushes alongside irregular menstrual cycles and intermenstrual/postcoital bleeding
Although the diagnosis of menopause and peri-menopause, also called premature ovarian insufficiency is a clinical diagnosis, which hormone can be measured in women:
- aged 40-45 with menopause symptoms
- with change in menstrual cycle
- aged <40 with suspected menopause
1 - LH
2 - FSH
3 - oestrogen
4 - progesterone
2 - FSH
- need 2 separate samples 4-6 weeks apart
Low FSH can lead to low oestrogen, and body thinks it is going through menopause
Women who are peri-menopausal, also called premature ovarian insufficiency should be advised to go on HRT therapy until the age of natural menopause.
True or False?
- True
What % of women in menopause experience symptoms of menopause?
1 - 10-15%
2 - 20-30%
3 - 50-60%
4 - 80-90%
4 - 80-90%
Symptoms typically last 7 years
25% of patients have debilitating symptoms
Patients who are peri-menopausal, also called premature ovarian insufficiency or menopausal can experience a variety of vasomotor symptoms. But which 2 of the following is by far the most common?
1 - hot flushes and night sweats
2 - mood disturbances
3 - brain fog
4 - vaginal/urethra atrophy
5 - osteoporosis
6 - cardiovascular disease
1 - hot flushes and night sweats
- 70-80% of women experience this
3 - brain fog
- become more aware of in primary care
Osteoporosis is commonly linked with menopause and ageing in women. Low levels of which hormone has been identified as the cause of this?
1 - leutenising hormone
2 - progesterone
3 - estrogen
4 - follicular stimulating hormone
3 - estrogen
Low estrogen is also linked with increased CVD and dementia risk
In addition to estrogen, which hormone is important for maintaining a healthy endometrium and reducing the risk of endometrial cancer?
1 - testosterone]
2 - growth hormone
3 - progesterone
4 - all of the above
3 - progesterone
Testosterone can be useful in treating loss of libido, low mood or energy levels.
It is currently not licensed in the UK but is often still prescribed especially in HRT clinics
Although menopause or peri-menopause may be the most likely diagnoses, it is important to rule out other differentials. Which 2 of the following should be performed if a patient has a low impact fracture or family history of osteoporosis?
1 - FBC
2 - renal function
3 - X-ray
4 - DEXA
3 - X-ray
4 - DEXA
Women who are experiencing menopause can experience significant mood swings. This is linked to low estrogen, which has been linked to causing low levels of which neurotransmitter?
1 - glutamate
2 - serotonin
3 - dopamine
4 - GABA
2 - serotonin
- linked to insomnia, mood swings, anxiety, poor concentration and loss of libido
Vaginal/urethra atrophy can be a common symptom that occurs in women going through peri-menopause or menopause. Which of the following can subsequently occur?
1 - dysparuria
2 - dysuria
3 - vaginal bleeding
4 - polyuria
5 - urge incontenance
6 - all of the above
6 - all of the above
As women age the number of oocytes declines and by the time women are >45 only a few thousand remain. Does the oocytes sensitivity increase or decrease in response to FSH and LH >45 y/o?
- decreases
- leads to amenorrhea
In menopause, beyond 45, oocytes have less sensitivity to FSH and LH. Does this then increase or decrease the levels of estrogen, progesterone and testosterone?
- decreases levels of all 3
In menopause, beyond 45, oocytes have less sensitivity to FSH and LH. Reduced sensitivity casues estrogen, progesterone and testosterone levels to reduce. Do the low levels of these hormones then cause an increase or decrease in FSH and LH?
- LH and FSH increase
- NO negative feedback loop to inhibit the hypothalamus and pituitary gland