Menopause Flashcards
Define Menopause
when menstruation stops permanently due to the loss of ovarian follicular activity - Dx 12 months of consecutive amenorrhoea
Averge menopausal age in the UK
51
Define Perimenopause
is the period before the menopause when the endocrinological, biological, and clinical features of approaching menopause start
Perimenopause Sx
irregular cycles of ovulation and menstruation and ends 12 months after the last menstrual period
Define Postmenopause
the time after a woman has not had a menstrual period for 12 consecutive months
Define Early menopause
the cessation of ovarian function occurring between the ages of 40 and 45 years, in the absence of other causes of secondary amenorrhoea
Define Premature menopause
definitive loss of ovarian function before the age of 40 years
Menopause Ix
Hormonal screening
- Oestrogen
- Progesterone
- LH
- FSH
Menopause hormonal screening findings
- LOW oestrogen + porgesterone
- High LH + FSH
No -ve feedback from oestrogen
Perimenopausal Symptoms
Hot flushes
Emotional lability or low mood
Premenstrual syndrome
Irregular periods
Joint pains
Heavier or lighter periods
Vaginal dryness and atrophy
Reduced libido
Menopause complications
- Osteoporosis
- Cardiovascular disease
When is FSH testing indicated in menapause
- < 40 years w/ meanopausal Sx
- 40-50 years w/ Irregular cycles with vasomotor symptoms
2 types of cyclical HRT
- Monthly HRT daily oestrogen + progesterone for the last 14 days of MC
- 3 monthly HRT daily oestrogen + progesterone for 14 days
Women with a uterus HRT option
combined HRT (progesterone & oestrogen)
Women without a uterus HRT option
oestrogen only
Oral HRT Risks
- increase VTEs
- increases chance of a stroke
Perimenopausal HRT option
Cyclical combined (daily oestrogen +14D progesterone) HRT
Post-Menopausal HRT option
Continuous combined (progesterone+oestrogen) HRT
Urogenital menopausal only Sx Tx
Vaginal moisturiser and lubricants
Menopause diagnostic criteria
- 12 consecutive months of amenorrhea (no periods) in women not using hormonal contraception
- Symptomatic diagnosis in women without a uterus
HRT contraindications
- Hormone-dependent breast, endometrial, or ovarian cancers
- Undiagnosed bleeding
- Active VTE/arterial disease
- Liver disease
- BMI > 30
- Migraine w/ aura
- Uncontrolled HTN
HRT indications
- Menopausal vasomotor Sx: hot flushes, night sweats
- irregular periods
HRT assoc. risks
- Breast ca.
- VTEs
- Stroke
- Ovarian ca.
- Endometrial ca.
- CVD
HRT option for VTEs/stroke (e.g. BMI >30) risk women
Transdermal HRT
