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Menopause Flashcards

1
Q

What is the technical definition of menopause?

A

12 consecutive months with no menstrual bleeding

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2
Q

What is perimenopause?

A

The period before menopause that is the transition from the reproductive to nonreproductive years, when ovarian estrogen fluctuate unpredictably

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3
Q

What is climacteric?

A

The time at which the changes of menopause occur

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4
Q

What happens to the menstrual cycle during the 4 years prior to menopause?

A

Irregularities

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5
Q

What is the average age of menopause?

A

51

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6
Q

What is the relationship between menopause and age of menarche? Race? Parity?

A

No relation to any of these

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7
Q

True or false: tobacco use causes earlier menopause

A

True

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8
Q

True or false: EtOH use causes earlier menopause

A

False–longer

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9
Q

What happens to the follicles with menopause?

A

Become resistant to FSH stimulation, causing the estrogen to fall

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10
Q

Why is it that estrogen levels do not fall completely once menopause hits?

A

Peripheral conversion and fat

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11
Q

What happens to progesterone production with menopause? What indicates this?

A

Stops production, causing PMS s/sx to disappear

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12
Q

Why is there an increased risk for endometrial hyperplasia with menopause?

A

Loss of progesterone together with a lack of estrogen loss

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13
Q

What happens to androgen production with menopause? SHBG? What is the significance of this?

A

Decreases

Increased testosterone could be causing hirsutism in some women

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14
Q

What happens to FSH and LH levels with menopause?

A

Increased drastically d/t lack of estrogen production

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15
Q

What are the s/sx of menopause?

A
  • Oligomenorrhea

- Somatic and psych changes

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16
Q

What are the psych s/sx of menopause?

A
  • Depression
  • Anxiety and irritability
  • Loss of libido
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17
Q

What are the “vasomotor instability” s/sx of menopause?

A

Changes in neurotransmittersr and prostaglandins cause SNS activation

“hot flashes”

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18
Q

What is the cardinal symptom of menopause? How often does this occur?

A

Hot flashes–75% of women

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19
Q

What neurotransmitter concentration changes with menopause?

A

5HT

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20
Q

What happens to sleep with menopause?

A

Decreased REM

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21
Q

What happens to short term memory with menopause?

A

Changes

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22
Q

What are the urologic s/sx of menopause?

A

Urinary frequency
Urgency
Nocturia

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23
Q

Urogenital atrophy with menopause causes what s/sx?

A

Pruritis
Dryness
Dyspareunia

24
Q

What is the #1 morbidity in menopausal women?

A

Osteoporosis

25
What is the RANKL receptor?
Receptor on osteoblasts that activates osteoclasts. Is upregulated with the presence of PTH
26
What bones are assessed with a DEXA scan?
Spine and the hip
27
What defines osteoporosis with a DEXA scan?
Less than 2.5 SDs from normal
28
True or false: bone marker correlate well with bone density
False
29
What are the meds that can be used to decrease bone loss?
Estrogen | SERMS
30
Below what weight would you want to screen for bone loss earlier than age 65?
Under 127 lbs
31
What causes the increased risk of CVD in menopausal patients?
Lack of estrogen causes: - Decrease HDL - Increase TG - Ratio of TC:HDL increases
32
HDL less than what is a risk factor for heart disease?
Less than 50
33
An increase in TG levels above what level is a risk factor for CVD?
More than 400 mg/dL
34
A ratio of TC:HDL to more than what is a risk factor for CVD?
More than 4
35
What causes the blood tinged discharge with menopause?
thinning of the vaginal canal
36
In whom can estrogen alone be used to treat the s/sx of menopause? What about E + P?
E alone if no uterus Need E+P for uterus
37
What are the risk factors for HRT?
- Endometrial hyperplasia | - Slight increase in breast cancer
38
True or false: there is an increase in HTN with HRT
False
39
True or false: there is a large increase in CVA/MIs with HRT
False--only slight increase
40
When should HRT begin?
Close to menopause--if menopause for a long time, then there is a risk for VTEs
41
True or false: exogenous estrogen increases the risk for colon cancer
False--decreases
42
True or false: exogenous estrogen improves dental health
True
43
Breast cancer within how many years is a contraindication to HRT
within the last 5 years
44
True or false: VTEs at any age is a contraindication for exogenous estrogen at menopause
True
45
How long should HRT be used to treat menopause?
Absolutely less than 5 years, but really only for the duration of s/sx
46
What are the side effects of estrogen/progesterone replacement therapy?
Similar to the s/sx of menstruation
47
BMI should be below what value to help with menopause
29
48
How often should weight bearing exercise be performed to prevent complications from menopause?
30 mins, 3x/wk
49
What are SERMS?
Estrogen-like agonists and antagonistic effects on specific target tissue
50
What is the major side effect of tamoxifen?
Proliferative effect on the uterus
51
What is the effect of Raloxifene on the uterus?
No proliferation
52
What are the non-steroidal options for menopause?
- SSRIs | - Clonidine for hot flashes
53
True or false: acupuncture has been proven to alleviate vasomotor s/sx of menopause?
True?
54
What are bioidentical hormones?
Plant hormones that carry the same risk as HRT
55
What is premature ovarian failure? What is the treatment?
Menopause the occurs spontaneously before 40 yo. May be 2/2 chemo or surgery -HRT immediately

OB/GYN (33 decks)

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