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womens health > Menopause > Flashcards

Menopause Flashcards

1
Q

what is perimenopause/menopausal transition

A

the period leading up to and immediately following menopause

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2
Q

what is menopause

A

final menstrual period

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3
Q

what is post menopause

A

the phase of life that comes after menopause

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4
Q

premature menopause

A

final menstrual period before age 40

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5
Q

how long does perimenopause last?

A

variable 1-3 years, but may begin 6years before menopause and continue for a variable number of years after menopause
extends to 12 months after menopause

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6
Q

what is the patho of menopausal transition

A

decline in quantity and quality of follicles.
ovaries lose sensitivity to gonadotropin stimulation and serum inhibin B levels and estrogen levels decrease
Anovulatory cycles
Irregular Pattern of gonadotropin and steroid production
Estrogen insensitivity

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7
Q

what happens with permanent amenorrhea

A

once all follicles are depleted FSH remains elevated for life

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8
Q

signs of perimenopause

A 
hot flashes
irregular menses (metrorrhagia, oligomenorrhe, polymenorrhea)
Insomnia
vaginal dryness
depression symptoms
increased hirsuitism
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9
Q

what is the MC symptom of perimenopause/MT

A

hot flashes

observed in 75% of women

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10
Q

hot flashes are described as

A

feeling heat/burning in the face, neck and chest followed by immediately by sweating outbreak over the whole body

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11
Q

what is the Tx for perimenopause

A 
estrogen
Oral contraceptives- low dose estrogen
SSRI and SNRI-1st alternative to hormones
soy products
black cohosh
Gabapentin
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12
Q

what is the DDx for vaginal dryness

A

stress
meds- anti-histamines
vulvar lesions
menopause

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13
Q

what is the Tx for vaginal dryness

A

Lubricants prior to intercourse
Moistureizers
Vitamin E oil

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14
Q

what is menopause

A

last menses/cessation of menses

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15
Q

how is menopause diagnoses

A

after 12months of amenorrhea

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16
Q

what is the average age of menopause

A

50-51

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17
Q

what is the only risk factor associated with early menopause

A

smoking

18
Q

what are the hormonal changes that are taking place during menopause

A

d/t decline in the function of the ovaries- decreased production of estradiol and progesterone
d/t decline in progesterone and estradiol there is an increase in LH/FSH (FSH>LH)

19
Q

what are physical changes of the reproductive tract in menopause

A 
atrophy of labia majora
atrophic changed of vaginal epithelium
vaginal wall become smooth
cervix decreases in size and become stenotic 
uterus shrinks
fibroids 
ovaries decrease in size
loss of pelvic muscle tone
20
Q

what is atrophic vaginitis

A

atrophy of epithelium w/ decreased blood supply
this results in smooth, thin, shiny, pale surface
more susceptible to trauma

21
Q

what is the symptoms of atrophic vaginitis

A

dryness, spotting, vaginal pain/burning, dyspareunia

urinary symptoms

22
Q

what is the Tx for atrophic vaginitis

A

mositurizers, lubricants, vit E oil

estrogen vaginal creams or rings

23
Q

what are other physical signs of menopause

A 
decreased breast size
thinning hair/skin
depression
memory loss
decreased libido
osteoporosis
CAD
24
Q

what are the 3 most important effects of menopause to paitents

A

symptoms
osteoporosis
cardiovascular disease

25
Q

how do treat their symptoms control

A 
Hot flashes:
dress in layers
Supplements (soy, black cohosh)
Estrogen replacment therapy
SSRI, SNRI, gabapentin
Vaginal dryness:
lubricants, moisturizers, Vit E oil
Topical estrogen
Decreased Libido:
estrogen replacement therapy
androgen therapy
26
Q

when do women lose up to 20% of their bone mass with osteoporosis?

A

first 5-7 years

27
Q

how is osteoporosis treated?

A 
weight bearing exercise
Calcium/Vit D supp.
Bisphosphanates
calcitonin
Estrogen
PTH
SERM (selective estrogen receptor modulators)-Raloxfine
28
Q

what happens to CV risk with women after what age?

A

> 60 CAV women=men
risk of cardiovascular dx increases 2-3 times that of a women the same age before menopause
they thinks its d/t estrogen

29
Q

multiple studies and trial have shown what with HRT

A

posed more health risks than benefits particularly when given to older postmenopausal woman
only useful in certain women depending of RF

30
Q

what did the HERS study (Heart and estrogen replacement study) show

A

there was no reduction in risk of MI or coronary event

showed increase of MI during 1st year of HRT

31
Q

WHI results with estrogen plus progesterone

A

Increased risk of MI, Stroke, Blood Clots, Breast Cancer

Reduced risk of Colon cancer
fewer fractures
no protection with cognitive impairment

32
Q

WHI results with Estrogen ALONE?

A

no difference in MI risk
Increased risk of stroke/ blood clots
not sure about breast cancer or colon cancer
reduced risk of fracture

33
Q

what are the FDA approved indications for HRT?

A 
prevention of osteoporosis
Tx vasomotor symptoms
Tx vulvovaginal atrophy
use lowest does for shortest time
women with a uterus need to take estrogen and progesteron to prevent uterine cancer
34
Q

what are the benefits of estrogen plus progesterone

A

lower colorectal cancer
lower risk of Fx
improves vasomotor and GU symptoms

35
Q

what are the benfits of estrogen alone in women w/o uterus

A

lower risk of Fx

improves vasomotor and GU

36
Q

what are the risk of estrogen/progesterone in menopause

A

Increased risk of MI, stroke, blood clots, breast cancer, gall bladder dz

37
Q

what are the risks of estrogen alone in menopause

A

increase risk of stokes, blood clots and gallbladder dz

38
Q

what are the benefits of local topical HRT?

A

little systemic absorption
estradiol level remain in the postmenopausal range
endometrial safety is maintained

39
Q

what are CI for HRT

A 
undiagnosed vaginal bleeding
Hx of breast cancer
estrogen dependent neoplasia
Active or HX of DVT/PE
Thrombolic dz (stroke,MI)
endometrial cancer
40
Q

what needs to be used with women who have an intact uterus?

A

estrogen/progesterone

womens health (6 decks)

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