Menopause Flashcards
Define Menopause
Permanent end of menstruation & fertility, defined as occurring 12 months after the last menstrual period
When does menopause typically occur?
Typically occurs between 45 & 55 years of age
What factors promote early menopause?
- Women w/ partial hysterectomy average 3.7 years earlier than expected age
- Factors promoting earlier onset (1-3 yr)
A. Smoking or being extremely thin
What symptom is commonly experienced by women approaching menopause?
DUBis often experienced by women approaching menopause
What are the 2 types of menopause?
- Physiologic menopause
2. Artificial menopause
What is physiologic menopause?
Oocyte response to gonadotropin stops
What is artificial menopause?
Permanent cessation of ovarian function brought on by surgical removal of ovaries or by radiation therapy
What hormonal changes occur during menopause?
- ↑ Testosterone
- ↓ Estrogen
- ↓ Progesterone
- ↑ FSH & LH
What sxs may occur with menopause?
- Gradual dec in both amount & duration of menstrual flow leads to spotting and amenorrhea
- Atrophic changes of vaginal epithelium
A. Thinning of epithelium
B. ↓ cervical & vaginal mucus production
C. ↓ size in uterus & ovaries - Atrophic bladder changes
A. Urinary freq, urgency, dysuria - Regression of breast size
- Hot flashes
A. Feeling heat or burning in face, neck, chest, followed by outbreak of sweating - Osteoporosis
- Skin & hair
A. Both become thinner
What diagnostic tests are used for menopause?
- Testosterone
- Estradiol
- Progesterone
- FSH/LH
- TSH
- Endometrial histology
How are the symptoms of menopause treated?
- Hormone replacement therapy
2. Bisphosphonates
What complications are associated with HRT?
- Endometrial cancer
- Breast cancer
- HTN
- Thromboembolic Dz
What are the contraindications to HRT?
- Undiagnosed vaginal bleeding
- Acute or chronic liver Dz
- Acute vascular thrombosis
- Endometrial cancer
- Breast cancer
What are the indications for HRT?
- Vasomotor Sx’s
A. Leads to ↓ frequency of hot flashes - Urogenital tract
A. Reverses postmenopausal atrophy of vulva, urethra and trigone - Osteoporosis
A. ↓ Resorption of bone but has no effect on bone formation
B. ↓ Frequency of hip fx
What alternative therapy may be used for the symptoms of menopause?
- Soy has isoflavones (plant estrogens)
A. Food form only - Flaxseed- omega-3 fatty acids & lignans (plant estrogen –like)
- Avoidcaffeine& alcohol
- Vit E: only up to 400 IU per day for hot flashes
- Estroven: hot flashes
- Vit B complex: hot flashes and mood swings
- Black cohoshderived from buttercup
A. May lowerBP & in rare cases hepatitis reported
