Menopause Flashcards
def. meno
12 months of amen
- associated with permanent cessation of ovarian function
def. perimenopause
transtitional period prior to menopause: from end of normal ovulatory cycles to cessation of menses
- heralded by menstrual irregularities
what is mech of perimeno
- by mid 40s, cycle is longer due to less E prolonging foll. phase - defines onset
- when length over 42 days can predict within 1-2 years
what are normal and premature ages
normal - 51yo
early meno
where does E come from in meno
peripheral conversion of andro to E
- correlates with body wieght
3 key points
- meno is clinical diagnosis
- not biochem
- no ultrasound diagnosis
why is it important to define
any bleeding post meno is abnormal - endo CA until proven otherwise
4 causes of PMB
- atrophic endometriosis/vaiginitis - 43%
- endo CA - 29%
- endo/cerv polyps
- other - trauma, sarcoma
what is first test
endo biopsy
what is impact of menopausal E deprivation
- vasomotor Sx
- urogential atrophy
- cog. changes
- CV changes
what is hot flush
sudden increase in redness and heat
- second s to minutes
- more often at night and in warm env
what is patho of hot flush
- poorly understood
- probably due to hypothalmus in assoc. with E deprivation
prevalence of hot flush
perimeno -10-25%
meno - 50-85
10 years past -
2 main treatments
firstline - lifestyle
Est - gold standard, but high placebo effect
what is urogenital atrophy
E deprivation
- cuases loss of collagen and thinning and friable
