Menopause Flashcards

1
Q

Blood test for menopause?

A

Unreliable

FSH usually gradual rise

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2
Q

Menopause hormones?

A

Decreased estradiol/progesterone

Androgen same

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3
Q

Premature menopause is when?

A
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4
Q

Smoking and menopause?

A

1-2 years earlier if smoker

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5
Q

Hysterectomy for menopause?

A

Reduced age of menopause

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6
Q

Menopause cause?

A

Run out of oocytes

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7
Q

Accelerated loss of ovarian primordial follicles at what age?

A

37

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8
Q

Risk of irregular anovulatory cycles?

A

Prolonged unopposed estrogen
Endometrial hyperplasia and cancer
NEEDS investigations

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9
Q

Consequences of menopause? Short term?

A

Vasomotor symptoms (hot flushes)
Vaginal dryness, atrophic vaginitis
Sleep disturbance
Mood disturbance

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10
Q

Medium to long term consequences of menopause? More likely if early menopause

A

Bone density
Risk of #s
Alzheimer’s
Cardiovascular

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11
Q

Ask what for menopause?

A

What is impacting them the most? Directs management

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12
Q

What happens if you have irregular periods in the perimenopausal time?

A

Need to investigate, could be endometrial cancer, pregnant,

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13
Q

When do hot flushes end?

A

50% Most women: will last 5-8 years

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14
Q

What are skeletal toxin?

A

Excess alcohol and caffeine

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15
Q

Iatrogenic causes of premature menopause?

A

Chemo or radiation for cancers

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16
Q

When is early menopause?

17
Q

When is premature menopause?

18
Q

Other reasons for premature menopause? Genetic?

A

Turner’s, fragile X

Autoimmune

19
Q

Dx of premature menopause?

A

Amenorrhoea greater than 4 months

20
Q

Dx of premature menopause?

A

FSH, E2 on two occasions
Prolactin, TFT bHCG
Karyotyping

21
Q

What is in HRT?

A

Estrogen to treat symptoms

Progesterone to protect endometrium

22
Q

Best way to give HRT?

A

Transdermal, less likely to get DVTs

23
Q

What to do with premature menopause HRT?

24
Q

HRT used for how long?

A

Shortest time, lowest dose to take care of symptoms

25
Oestrogen alone bad how?
Risk of trike VTE, PE Cholecystitis Endometrial hyperplasia and cancer for woman with uterus
26
Combined HRT risks?
Breast cancer IF >5 years
27
Contraindications for HRT
Hormone sensitive cancers
28
Tibolone is?
Weak estrogen
29
What do no hormonal therapies change?
Only vasomotor symptoms | NOT depression, sleep, urogenital.
30
What available non-hormonal therapies?
Gabapentin SSRI/SNRI Clonidine