Menopause Flashcards
When can menopause be diagnosed?
When it has been a year since menstruation
What is the average age of the menopause?
52
Levels of which hormone peak around the menopause?
FSH
On who would you want to do an FSH level test on to confirm menopause?
Women undergoing menopausal symptoms below 45
What do the FSH levels have to be to officially diagnose menopause?
Over 30 on 2 separate occasions
What type of oestrogen is higher in premenopausal women?
Oestradiol
What type of oestrogen is higher in postmenopausal women?
Oestrone
Which type of oestrogen is more biologically active; oestrone or oestradiol?
Oestradiol
Which type of oestrogen is produced peripherally by conversion of androgens in adipose tissue?
Oestrone
How is oestradiol produced?
Ovaries
How is oestrone produced?
By conversion of androgens in adipose tissue
What are the acute symptoms of the menopause?
Hot Flushes Night sweats Reduced libido Headache Fatigue Low mood
Who is eligible for oestrogen only HRT?
Women who have had a total hysterectomy
Women who have a mirena coil (for 4 years)
How long should you use sequential HRT for?
Maximum of 5 years. Should switch to continuous after 2 years
Who should get sequential combined HRT?
Peri menopausal women with a uterus
Describe how sequential HRT works
Oestrogen taken every day fro 28 days. Progesterone taken for the last 10 - 14 days of this.
Describe how continuous combined HRT works
Oestrogen combined with progesterone taken for 28 days
When should continuous combined HRT start?
Shouldn’t be started until 1 year after the LMP or aged 54
Or after 2 years of sequential therapy if under 54
A women on HRT is still suffering from loss of libido. What might help?
Testosterone (patch/implant)
What is used for women with vaginal dryness and vulval irritation who do not want oral HRT?
Local oestrogen gels/creams
What is tibolone?
A synthetic steroid drug with estrogenic, progestogenic and weak androgenic actions. used to relieve menopausal symptoms (particularly vasomotor)
What non oestrogen drugs are used to relive menopausal symptoms?
Clonidine
SSRIs
SNRIs
Gabapentin
Which type of HRT has the highest risk of breast cancer?
Combined
What preparation of HRT would you give to a women at higher risk of VTE and why?
Transdermal patch (bypasses the liver)
