Menopause

Question 1

Permanent cessation of menstration that occurs after the loss of ovarian activity

Answer 1

Menopause

Question 2

When can menopause be determined?

Answer 2

1 year after last menstrual period

Question 3

What is the median age for menopause?

Answer 3

51 years

Question 4

What is the menopause transition known as?

Answer 4

Perimenopause

Question 5

Estradiol and progesterone ____ during the menopause transition

Answer 5

Decrease

Question 6

FSH _____ during the menopause transition

Answer 6

Increases

Question 7

If a patient is having symptoms of menopause that are not “classic”, what should you order and why?

Answer 7

Prolactin to r/o hyperprolactinemia

TSH to r/o hyperthyroidism

Urine hCG

Question 8

When do symptoms of menopause usually start?

Answer 8

about 4 years before final menses (usually age 47)

Question 9

Should you check FSH to diagnose menopause?

Answer 9

No! Hormone levels fluctuate

Question 10

Normal level of FSH during menopause?

Answer 10

Greater than 25

Question 11

What proliferates the endometrium?

Answer 11

Estrogen

Question 12

When does progesterone increase during the menstrual cycle?

Answer 12

After ovulation (Day 14)

Question 13

When does estrogen start to decrease during the menstrual cycle?

Answer 13

After ovulation (Day 14)

Question 14

What causes the endometrium to shed during menstruation?

Answer 14

Decreasing progesterone levels

Question 15

What are the symptoms of menopause?

Answer 15

Vasomotor (hot flashes)
Vaginal symptoms
Sleep disturbances
New-onset depression

Question 16

Sudden sensation of extreme heat in the upper body, particularly the face, neck, and chest

Answer 16

Vasomotor symptoms

Question 17

What characterizes vasomotor symptoms?

Answer 17

Perspiration, flushing, chills, clamminess, anxiety, heart palpitations

Question 18

What can help manage the vasomotor symptoms of menopause?

Answer 18

Administration of estrogen

Question 19

Why does the body become more sensitive to subtle changes in core body temperature?

Answer 19

Estrogen widens the regulatory zone of body temperature; less estrogen means narrower thermoregulatory zone

Question 20

What causes vaginal atrophy?

Answer 20

Hypoestrogenic state

Question 21

What are the symptoms of vaginal atrophy?

Answer 21

Vaginal or vulvar dryness
Discharge
Itching
Dyspareunia

Question 22

What increases the risk of urogenital infections in menopausal women?

Answer 22

Vaginal pH becomes more alkaline

Question 23

Data suggests that transdermal estrogen may have ____ risk of DVT compared to oral regiments

Answer 23

Lower

Question 24

If your patient has a hysterectomy and is showing vasomotor symptoms, what do you treat her with?

Answer 24

Estrogen alone

Question 25

If your patient has NOT had a hysterectomy and is showing vasomotor symptoms, what do you treat her with?

Answer 25

Estrogen AND progesterone combination (prevents endometrial hyperplasia)

Question 26

What is the precursor to endometrial cancer?

Answer 26

Endometrial hyperplasia

Question 27

How do you treat women with hormone therapy?

Answer 27

Start at the lowest dose for the shortest duration that is needed to relieve vasomotor symptoms

Question 28

How many years should HT use be limited to?

Answer 28

5 years

Question 29

What are the side effects of hormone therapy?

Answer 29

Breast tenderness Vaginal bleeding Bloating Headaches

Question 30

When do you discontinue hormone therapy?

Answer 30

Individualized based on the woman