Menopause Flashcards
Definition of menopause
The term natural menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity where the last period was 12 months prior
Definition of premature menopause
Menopause occurring before 40 years of age
Definition of induced menopause
The term induced menopause is defined as the cessation of menstruation which follows either surgical removal of both ovaries (with or without hysterectomy) or iatrogenic ablation of ovarian function (e.g. by chemotherapy or radiation)
Definition of climacteric/ perimenopause
The period of time when ovarian function declines and menopausal symptoms appear
Definition of post menopause
The time after menopause
What are the symptoms of menopause?
Irregular periods
Vasomotor: hot flushes, night sweats, formication
Psych: mood disturbance (depression), emptiness syndrome, decreased libido
General: sleep disturbance, dry skin, hair loss, muscle/ joint pain
Urogenital: vaginal dryness and atrophic vaginitis, painful intercourse, urinary frequency and dysuria
What are the causes of premature menopause?
Idiopathic - premature ovarian failure Iatrogenic - surgery, chemotherapy/ radiotherapy Genetic - Turner's syndrome, Fragile X Autoimmune Galactosaema (rare)
What are the Ix for premature menopause?
FSH Oestrogen Prolactin TFTs bHCG Karyotype and Fragile X
What are the implications of premature menopause?
Menopausal Sx Increased CVD risk Increased OP risk Increased depression Loss of fertility
What are the treatments for hot flushes?
Cognitive behavioural therapy Hormone replacement therapy Anticonvulsants e.g. gabapentin Clonidine SSRI/SNRIs Tibolone
What are the treatments for vaginal dryness?
Topical oestrogen
Hormone replacement therapy
Lubricants
Vulval anaesthetic
What are the treatments for decreased libido?
Tibolone
What are the risks and benefits of HRT?
Risks: increased breast cancer risk, increased VTE and stroke risk, increased CVD risk in older women
Benefits: reduced menopausal symptoms, fracture risk, reduced colorectal cancer risk
