Menopause

Question 1

menopause signifies the depletion of _____ and manifest as what?

Answer 1

oocytes; absence of menses

Question 2

what are the gonadotropin levels in pts in menopause?

Answer 2

elevated due to decreased estrogen levels

Question 3

at what time is menopause officially diagnosed?

Answer 3

after 6-12 months of amenorrhea

Question 4

menopause is preceded by what period?

Answer 4

climacteric or periomenopausal period

Question 5

what is the average age of menopause in the United States?

Answer 5

51 y/o

Question 6

t or f: cigarette smoking is a factor known to significantly increase the age of menopause

Answer 6

FALSE - it reduces the age of menopause (by 3 years)

Question 7

t or f: genetics plays a role in the age of onset for menopause

Answer 7

TRUE

Question 8

what is the physiology behind the perimenopausal period that invovles the oocytes dying?

Answer 8

the oocytes begin to die precipitously (via apoptosis) and become resistant to FSH (which is responsible for their maturity)

Question 9

what happens to inhibin levels during menopause?

Answer 9

they are decreased because b/c it is produced in smaller amounts by fewer oocytes; (remember, inhibin inhibits FSH)

Question 10

what happens with the requirement of FSH with resistant oocytes?

Answer 10

FSH requirements go up which triggers greater FSH release

Question 11

do perimenopaual women ovulate more or less frequently? why?

Answer 11

less - due to shortened follicular phase (because again, fewer eggs!!) - this oligo/anovulation leads to abnormal bleeding in perimenopausal women

Question 12

pain during intercourse, vaginal itching and few epithelial cells on wet mount prep is consistent with what diagnosis?

Answer 12

atrophic vaginitis

Question 13

what is the cause of atrophic vaginitis?

Answer 13

decline estrogen

Question 14

at what age is considered late menopause?

Answer 14

menopause after age 55

Question 15

premature ovarian failure is defined as menopause occurring before what age?

Answer 15

40

Question 16

what is the major estrogen circulating in menopausal women?

Answer 16

estrone (less potent than estradiol)

Question 17

what happens to androstenedione and testosterone levels during menopause?

Answer 17

they fall (b/c remember these are made by the ovary)

Question 18

what is the mainstay of treatment for the physiologic effects of menopause?

Answer 18

HRT/ER

Question 19

what does decreased estradiol do to cholesterol levels? (x2)

Answer 19

increases LDL and decreases HDL

Question 20

what effect does decreased estradiol have on the bones?

Answer 20

causes osteoporosis

Question 21

what effect does decreased estradiol have on the vaginal mucous membranes?

Answer 21

atrophy and dryness

Question 22

what effect does decreased estradiol have on the urethra?

Answer 22

loss of tone

Question 23

what effect does decreased estradiol have on the psyche?

Answer 23

lability and depression

Question 24

what effect does decreased estradiol have on the hair and skin?

Answer 24

skin less elastic, more wrinkled and hair reflecting more male growth patterns

Question 25

when is ERT indicated?

Answer 25

in women post hysterectomy

Question 26

what is the relationship between estrogen and blood clotting?

Answer 26

estrogen creates a hypercoagulble state bu increased production of hepatic coagulation factors

Question 27

t or f: HRT/ERT may worsen HTN and migraines

Answer 27

TRUE

Question 28

before HRT is initiated what test(s) should be done?

Answer 28

mammography

Question 29

for how long is it safe for women to be placed on HRT?

Answer 29

5 years

Question 30

t or f: HRT increases the risk of breast CA

Answer 30

TRUE