Menopause Flashcards
Define menopause.
Menopause is a physiological stage in all women which occurs when the finite number of ovarian follicles becomes depleted.
- Oestrogen and progesterone levels fall
- LH and FSH levels increases
- Menstruation becomes erratic and eventually stops
- Secondary symptoms occurs because of this
What is the average age of UK menopause?
51 years
When is menopause deemed to be early?
Early = <45 years
Premature ovarian insufficiency < 40 years
What are the causes of early menopause?
Idiopathic
FHx
Surgical removal of ovaries
Chemotherapy
Radiotherapy for pelvic cancer
Hysterectomy
What are the short-term clinical features of menopause?
- Hot flushes
- Sweats (night)
- Headaches, tiredness, irritability, difficulty sleeping, depression, anxiety, loss of libido
Period changes
-Change to cycle length, days in between, amount bleeding
What are the long-term effects of menopause?
Skin drier, thinner, more itchy
Genital area drier, sex more painful
Osteoporosis
Increased risk of CVD
What is the conservative management of dealing with menopause?
Encourage healthy lifestyle
What are the indications for hormone replacement therapy use?
- For menopausal symptoms where the risk:benefit ratio is more favourable in fully informed women
- For women in early menopause until the age of natural menopause (51)
- Women <60yrs who are at risk of osteoporotic fractures and where non-oestrogen supplements are beneficial
NB
HRT NOT RECOMMENDED IN WOMEN >60
What are the benefits of using HRT?
- Reduction vasomotor symptoms
- Reduction of mood symptoms
- Generally better sleep
- Improvement in urogenital symptoms
- Reduction of osteoporosis risk
What are the risks to using HRT?
Increased risk of
- Breast cancer
- Endometrial cancer
- Stroke
- Ischaemic heart disease (> 10 years after menopause)
What are the common side effects of HRT?
- Nausea
- Breast tenderness
- Fluid retention/weight gain
