Menopause Flashcards
How do we define menopause?
Amenorrhea x 12 months
ovaries stop working
What is the average age of menopause?
51.3 yoa (95% btwn 45-55)
What are the symptoms of menopause?
Hot flashes-70% (20% may seek tx) Night sweats Vaginal atrophy-dryness, itching, dyspareunia Insomnia Mood lability, irritablity Central obesity (Cholesterol and bones change)
What is perimenopause?
Ovaries aren’t as responsive Menses becomes irregular Symptoms: Hot flashes, night sweats, irregular menses 4-7 yrs, 47 average start
will estradiol be high or low during menopause? how about FSH?
estradiol = low FSH = high
how do we classify premature ovarian failure?
<40 onset of menopause Causes include: -Idiopathic -Surgical, radiation, chemotherapy -Chromosomal- 45XO, Fragile X I-nfectious-mumps, cmv -Autoimmune
What can HRT cause an increased risk of?
breast cancer
CHD
stroke
DVT
What does it decrease risk of?
colon cancer, fractures
What is the mantra for HRT?
lowest dose, lowest time
What are the medications that are available to help treat the symptoms of menopause?
Hormones
Non-hormones
Herbals
Describe the hormones that can be given
e/p combos
e only = must have had hysterectomy or only doing a cream
p only = still about 85% effective
When are hormones contraindicated?
Breast CA Endometrial CA Undiagnosed vaginal bleeding CHD Venous thrombosis Stroke Pregnancy NOT SMOKING!
What are some meds that are non-hormonal controls for menopause?
SSRI- paroxetine (Paxil) 60-65% effective SNRIs- venlafaxine (Effexor) 60-70% effective Gabapentin-(Neurontin)-anti seizure 60-70% effective Sedating --> good for night sweats Clonidine- anti hypertensive 45-50% effective
have herbals been shown to be effective?
no more effective than placebos
What is osteoporosis?
Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine
