Menopause Flashcards
What is the average age if menopause?
51yo
What is early menopause?
<45yo
What is premature menopause?
<40yo
What is late menopause?
> 54yo
How much ova do women have at birth?
~1million
What are the effects of oestrogen?
Secondary sexual characteristics Hair distribution, body shape & fat distribution Effect on collagen Bone growth Proliferates endometrium
How is menopause diagnosed?
Symptoms
Pattern of periods
Blood tests
Describe FSH and LH release
Released in pulsatile fashion
Single raised level does not confirm menopause
Raised just prior to ovulation
Raised with stopping COCP or depo
Raised with breastfeeding or certain medication (SSRI)
What are the physical symptoms of menopause?
Hot flushes Night sweats Palpitations Insomnia Joint aches Headaches
Describe hot flushes in menopause?
60-80% of women
20% severe
Average 2 years, 10% for 15yrs
Last 3-5mins
What are the psychological symptoms of menopause?
Mood swings Irritability Anxiety Difficulty concentrating Forgetfulness
What are the sexual symptoms of menopause?
Vaginal dryness
Loss of libido
What are later symptoms of menopause?
Increased urine frequency Recurrent UTIs Dysuria Incontinence Dry hair and skin Atrophy of breast and genitals
What perimenopausal DUB can occur?
Irregular periods
IMB
PMB
What is the conservative management of menopause?
Diet Wt loss Exercise Lifestyle Caffeine
What are some treatments for menorrhagia?
Mefenamic acid Tranexamic acid Progesterones Intra-uterine system Endometrial ablation Hysterectomy
In what forms can HRT be used in menopause treatment?
Oestrogen alone
Oestrogen and progesterone
Topical or oral
What are the benefits of HRT?
Symptom control
Quality of life
Reduced Osteoporotic fracture
Reduced Bowel cancer
Possibly protective Alzheimer’s & Parkinson’s diseases
HRT <10years after menopause fewer risks and less cardiovascular events
What are the risks of HRT?
VTE (2-7 extra /1000) CVA Breast cancer (6 extra /1000) Gallbladder disease HRT >20 years after the menopause greater risk of harm
What are some non-HRT menopausal treatments?
Clonidine SSRIs Regelle Yes Sylk
