Menopause Flashcards

1
Q

12 months of amenorrhea defines

A

menopause - permanent cessation of ov activity

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2
Q

Perimenopause is characterized by

A

irregular menstruation

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3
Q

In majority of women, cycle lengthens to how long

A

35 days - tiring ovary

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4
Q

What defines the onset of perimenopause

A

Prolonged follicular phase

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5
Q

When do you define anovulatory…

A

when cycle length > 42 days

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6
Q

what % of women cease menses without going through prior menstrual irregularity

A

10%

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7
Q

Median age of onset of perimenopause is

A

45 yo, duration ~ 5 years

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8
Q

menopause < 40 yo is

A

premature ovarian failure

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9
Q

What happens to FSH at Menopause

A

FSH > 40, no conception possible > 20

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10
Q

4 causes of post menopausal bleeding

A
  1. atrophic endometritis, vaginitis
  2. endometrial cancer/hyperplasia
  3. endometrial/cervical polyps
  4. cervical ca, uterine sarcoma, trauma
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11
Q

Women not on HRT, endometrial thickness should be

A

<= 0.5mm

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12
Q

What should be part of the work up for PMB

A

BIOPSY! NOT US

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13
Q

4 consequences of menopausal estrogen deprivation

A
  1. vasomotor
  2. urogenital atrophy
  3. cognitive changes
  4. CV changes
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14
Q

vasomotor hot flush occurs more frequently when?

A
  • at night, warmer environment
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15
Q

prevalence of vasomotor symptoms in perimenopause vs menopause

A

10-25% at perimenopause

50-85% at menopause

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16
Q

first line therapy in treating vasomotor symptoms

A

lifestyle modification, then estrogen!

17
Q

What are alternative drug therapies effective in treating vasomotor symptoms

18
Q

3 effects of estrogen deprivation of urogenital area

A
  1. thinning of vaginal walls
  2. dryness
  3. loss of tissue flexibility
19
Q

therapy for urogenital atrophy includes

A

lubricants

- local estrogen therapy

20
Q

3 types of local estrogen therapy

A
  1. premarin
  2. vagifem - tablets
  3. estring
21
Q

2 symptoms less certainty attributable to estrogen deprivation

A

mood changes

memory loss

22
Q

3 symptoms attributable to estrogen deprivation

A
  1. hot flushes
  2. urogenital atrophy
  3. POOR QUALITY OF DEEP SLEEP
23
Q

what is the role of progestin in HRT?

A

prevent endometrial cancer

24
Q

WHat did the WHI study show in the HRT group

A

increased risk of CAD

and invasive breast cancer (25%)

25
main issues with the WHI study
- average age of women 63 | - only 16% of women within 5 years of menopause
26
Roussouw study showed in 2007 JAMA that
increased risk of CAD is women in their 70s who were started on HRT
27
The increase in risk of HRT in breast cancer is seen
5 years after use - less than risk when late age at first pregnancy ! same as alcohol use!
28
Risks for CVD are only elevated when? after menopause
> 20 yrs out of menopause