Menopause Flashcards
What stages does the menopause consist of?
- Pre-menopause
- Menopause
- Post-menopause
When does pre-menopause begin?
Typically from ˜40 years, but variable
What is considered to be premature menopause?
Before early 30’s
What is premature menopause due to?
Follicular failure
What happens to ovulation in pre-menopause?
Ovulation is early is absent
What happens to oestrogen in pre-menopause?
Less oestrogen is secreted
What happens to LH and FSH levels in pre-menopause?
LH and FSH levels rise, FSH more
Why do FSH and LH levels rise in pre-menopause?
Reduced feedback
What happens to fertility in pre-menopause?
It is reduced
What is the menopause?
Cessation of the menstural cycle
What is the average of menopause?
49-50, but variable
When do menopause occur?
When there are no more follicles to develop
What is the indiciation that someone has passed from pre-menopause to menopause?
When there have been no menstrual cycles for 12 months
What happens to oestrogen levels in menopause?
They fall dramatically
What happens to FSH and LH levels in menopause?
They rise, FSH dramatically
What are the effects to menopause?
- Vascular changes
- Has effects on oestrogen sensitive tissues
- Effects on bone
What oestrogen sensitive tissues are affected in the menopause?
- Uterus
- Bone
- Cervix
- Vagina
- Breast tissue
- Skin
- Bladder/pelvic muscles
What is the effect of the menopause on the uterus?
- Regression of the endometrium
- Shrinkage of myometrium
What is the effect of the menopause on the cervix?
Thinning
What is the effect of the menopause on the vagina?
- Vaginal rugae lost
- Thinner, dryer
What is the effect of the menopause on breast tissue?
Involution of some breast tissue
What is the result of the changes in bladder and loss of pelvic tone in the menopause?
Increased risk of urinary incontinence
What is the effect of the menopause on bone?
Bone mass reduced by 2.5% per year for several years
Why does the menopause result in a loss of bone mass?
Reduced oestrogen enhances osteoclast ability to absorb bone
What does the loss of bone mass in the menopause lead to?
Osteoporosis
What does the fact that the severity of menopausal osteoporosis is much worse in some than others indicate?
That there are other factors, not just sensitivity to oestrogen
What is post-menopausal osteoporosis a major cause of?
Fractures in later life
How can post-menopausal osteoporosis be limited?
Oestrogen therapy
How can menopausal symptoms be treated?
Hormone replacement therapy
What are the advantages of hormone replacement therapy?
- Can improve well-being
- Can limit osteoporosis
Is HRT recommended for a first line protection against osteoporosis in menopause?
No
Is HRT adviced for cardioprotection in menopause?
No
How can HRT be administered?
Orally or topically, by patch or gel
Do males experience menopause?
No, there is no obvious events in males, and sperm production continues