Menopause Flashcards
wat is climacteric menopause
the bit leading up to the last period
what is the average age of menopause
51
when is early menopause
<45 years
when is premature menopause
<40 years
when is late menopause
> 54
what are some causes of premature menopause
genetic
chromosomal
radio/chemo
removal of ovaries due to endometriosis
how many ova at birth
1 million
what does FHS and LH from the ant pit do
cause granulosa cells to secrete oestrogens
what are oestrogens
collection of oestrogen like hormones such as estrodial
what leads to menopause
absence of oestrogens
what are some effects of oestrogen
secondary sexual characteristics hair distribution, body shape and fat distribution effect on collagen bone growth proliferates endometrium
what are the three ways menopause can be diagnosed
symptoms
pattern of periods
blood tests - FSH and LH
how is FSH and LH released
can a blood test for FHS and LH levels diagnose menopause
when is FHS and LH raised
released in pulsatile fashion
single raised levels do not confirm diagnosis, maybe is women has no uterus but not in isolation
raised poor to ovulation, stopping COCP or depo, raised breastfeeding or certain medication (SSRI)
what are some physical symptoms
hot flushes night sweats palpitations insomnia joint aches headaches
how many women have hot flushes
how many have severe symptoms
how long do they last
how long does each one last for
60-80%
20%
2 years but 10% for 15 yrs
last 3-5 minutes
what are hot flushes triggered by
anxiety, hot meals, change in temperature of the room or no trigger
what are some psychological symptoms
mood swings irritability anxiety difficulty concentrating forgetfulness
sexual symptoms of menopause
why do these occur
vaginal dryness due to withdrawal of oestrogen
reduced libido due to physical symptoms
libido can be stimulated by testosterone
what are some later symptoms
frequency recurrent UTIs dysuria incontinence dry hair and skin atrophy of breast and genitals
what is perimenopausal DUB
irregular periods because eggs aren’t being released regularly anymore
when does PMB occur
what should be done and why
bleeding a year after menopause
nees to be investigated with a pipelle biopsy as could be ovarian cancer
conservative management of menopause
diet - processed food makes symptoms worse weight loss exercise - reduces symptoms lifestyle caffeine
menorrhagia treatment
mefanamic acid is a NSAID reduced blood supply to the uterus
tranexamic acid anti fibrinolytic
progesterones - stabilises the lining of the womb and so its less likely to proliferate DEPO
IUS - releases low dose prog and is a contraceptive
endometrial ablation
hysterectomy
HRT
oestrogen alone - can cause endometrial hyperplasia or endometrial cancer - so only if hysterectomy
oestrogen and progesterone - increases risk for breast cancer compared to oestrogen alone
topical and oral
benefits for HRT
reduced osteoporotic fracture
reduced bowel cancer
risks for HRT
VTE
CVA
breast cancer
gallbladder disease
non HRT treatments
clonidine SSRIs regelle Yes sylk
when are non HRT treatments used
second line to HRT if breast cancer
