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Menopause Flashcards

1
Q

What are the health risks associated with menopause?

A

CVD (total LDL levels rise), osteoporosis, urogenital atrophy (pee issues), quality of life

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2
Q

What is the ave age of menopause in USA

A

52

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3
Q

What happens in ovarian development in week 4 of the fetus

A
  • Appearance of primordial germ cells in yolk sac
  • Migration of germ cells to genital ridge
  • Germ cell mitosis
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4
Q

What happens in ovarian development in week 6 of the fetus

A
  • Germ cells arrive at genital ridge

- Sex cord formation supports germ cells

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5
Q

What happens in ovarian development in week 8-12 of the fetus

A
  • Ovarian differentiation
  • Reproductive tract differentiation
  • Initiation of meiosis
  • oogonia become oocytes
  • Meiotic arrest in P1
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6
Q

What happens in ovarian development in weeks 16-20 of the fetus

A
  • Ovarian follicular formation

- Max oocyte number achieved (5-7 million)

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7
Q

What happens in the ovary in prepubescent state?

A
  • Waves of follicular development and atresia
  • No stimulation of ovary by pituitary gland
  • Minimal estrogen production
  • No ovulation occurs
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8
Q

How many germ cells does a female have by puberty?

A

300,000-500,000

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9
Q

About how many oocytes are selected to ovulate

A

400-500 (most undergo atresia)

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10
Q

Describe the rate of follicular atresia

A

Not fixed, becomes more rapid 10-15 years before menopause

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11
Q

Define menopause

A

The point in time when permanent cessation of menstruation occurs following the loss of ovarian activity (naturally or surgically)

  • This is a retrospective diagnosis (12 mo w/o pd)
  • FSH and LH are high, low estrogen
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12
Q

What is perimenopause

A

Time with menstrual irregularity and symptoms

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13
Q

What factors are related to age of onset of menopause

A
  • Smoking dec age by 1.5yrs
  • Family trends
  • Dietary habits (veg younger than meat)
  • Alcohol consumption and later
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14
Q

What is the health risks associated with perimenopause and post menopause?

A

metabolic syndrome

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15
Q

What are the menopausal symptoms?

A

Hot flash, urogential atrophy, muscoluskeletal symptoms, disordered sleep, mood (inc and exacerbated mood disorders)

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16
Q

What does smoking do to estrogen metabolism

A

Increases it! Thats why you hit menopause earlier and have more symptoms when you smoke

17
Q

What are some risk factors for dev menopausal symptoms?

A

Smoking, african american, obesity

18
Q

Treatment of menopausal symptoms

A
  • Hormone replacement therapy
  • SSRIs
  • Antihypertensives
  • Behavioral: diet, wt loss, dec smoking etc
19
Q

What is the prev of premature ovarian insufficiency?

A

1%/year

20
Q

What is premature ovarian insufficiency?

A

Cessation of ovarian fxn at or before 40y/o

21
Q

How do you diagnose premature ovarian insufficiency?

A

High FSH/LH and concurrent low estradiol on two sep occasions at least 1 mo apart

22
Q

Etiology of premature ovarian insufficiency?

A
  • Genetics
  • Autoimmune attack on ovaries
  • Metabolic disorders
  • Iatrogenic exposures (chemo etc)
  • Smoking
23
Q

Describe a genetic abnormality that leads to premature ovarian insufficiencey

A

Turner’s Syndrome, 45X–>premature ovarian failure and delayed puberty, both X chromosomes are req to be active in the ovary to ensure normal dev and maintenance of oocyte number. Get rapid atresia of oocytes.

24
Q

Describe how chemo/radiation lead to premature ovarian insufficiencey

A

Effects of chemo/radiation depends on age of pt at time of exposure, treatment field, type, dose, duration

  • Chemo causes damage to primordial follicles, alkylating agents are particularly damaging
  • Radiation to the pelvis=more damaging due to scatter
25
Q

What is a treatment option for premature ovarian insufficiencey

A

Hormone replacement therapy, fertility preservation in those treated for cancer (like IVF or oophoropexy where ovaries are surgically moved away from radiation field)

26
Q

What is important to know about ovulation and menopause

A

Menopause has nothing to do with ovulation!

Reproduction (23 decks)

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