Menopause Flashcards
Define menopause
- Permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity
- Need 12 consecutive months of no menstrual periods and no biological or physiological cause can be identified
What is the average age of menstruation
50
Define pathologic menopause
Gradual or abrupt cessation of menstruation before 40
Describe the changes in hormonal level at menopause
- Oestrogen levels begin a gradual decline at 40 as the number of primordial follicles approaches zero
- When oestrogen levels fall below a critical level, then it fails to negatively feedback and therefore LH and FSH levels rise
- FSH always higher than LH
- GnRH levels also rise at menopause due to no oestrogen feedback
What hormone is measured to assess for menopause
- FSH levels are measured to determine if menopause has occurred
- Oestrogen not measured as oestrogen not only produced from the ovaries
List some early signs of menopause
Hot flushes, sweating, insomnia, menstrual irregularity
- Frequent headache, mood swings, irritability, depression, insomnia
- Ovaries become smaller due to decreased oestrogen production (undergo atrophy)
Describe why dysfunctional uterine bleeding occurs in menopause
- Continued oestrogen causes the endometrium to keep thickening
- Leads to a late menstrual period followed by irregular bleeding and spotting
- Greater thickening of uterine wall
- No ovulation means no corpus luteum and therefore no progesterone production
- Increased risk of carcinoma - unopposed oestrogen (progesterone acts to control uterine wall development from oestrogen)
Why should oestrogen-only hormone therapy only be give to women who have had a hysterectomy
Women who have uterus have risk of developing uterine carcinoma due to unopposed oestrogen
Describe some intermediate changes that occur after menopause
- Skin loses its elasticity and becomes thin and fine
- Weight increase - irregular food habit due to mood swings
- Increased deposition of fat around hips, waist and buttocks
- Hair - dry and brittle
- Voice - become deeper due to thickening of vocal cords
- Digestive and urinary system
- Digestive tract diminished after menopause
- Urinary incontinence
- Breast - becomes flat and shriveled
Describe some long term changes that occur after menopause
- Bone - calcium loss from the bone leads to loss of bone density
- Oestrogen normally inhibits osteoclasts, therefore increased osteoclasts leads to increased recycling of bone
- Predisposes to osteoporosis
- CVS system - increased circulating levels of lipids
- Hyperlipidaemia can predispose to atherosclerosis
- Gradual rise in the risk of heart disease and stroke
Describe non-hormonal treatment for menopausal symptoms
- Dressing in light layers can alleviate hot flashes and night sweats
- Avoid caffeine, alcohol and spicy food
- Reducing dietary fat intake and regular exercise can reduce weight gain
List advantages and disadvantages of hormone replacement therapy
- Advantages of HRT
- Minimizes menopause symptoms
- Improve well-being
- Can limit osteoporosis
- Disadvantages of HRT
- Increased risk of blood clots
- Risk of heart disease
- Risk of breast cancer
