Menopause Flashcards

1
Q

What is the definition of menopause ?

A

Permanent cessation of menstruation at the end of reproductive life caused by failure of ovarian follicular development and oestrogen production

Time when there is no menstruation for 12 consecutive month and no other causes can be identified

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2
Q

What are the phases of menopause ?

A

Pre menopause
Peri menopause
Menopause
Post menopause

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3
Q

What is pre menopause ?

A

Time prior to menopause characterised by the start of changes in menstrual cycle

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4
Q

Which changes occur during the pre menopause phase ( hormones and cycle) ?

A

-follicular phase shorter , ovulation early or absent

  • low oestrogen
  • levels of LH and FSH rise , FSH more due to reduced negative feedback (low oestrogen and no inhibin )
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5
Q

What is peri menopause ?

A

Transition phase, characterised by physiological changes

Hot flush , dry skin…

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6
Q

What is the post menopausal phase ?

A

Time eater which a woman has experienced 12 months of amenorrhea

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7
Q

What causes menopause ?

A

Ovaries depleted of primordial follicle (primary ovarian failure) > cessation of menstrual cycle , production of oestrogen decreased dramatically > no more negative feedback on LH and FHS (no inhibin )

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8
Q

Which hormone is measured to diagnose physiological menopause ?

A

FSH and LH

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9
Q

What are the main symptoms of menopause ? What is the cause ?

A

Itching (dry skin)
Sweating and hot flush
Insomnia
Psychological symptoms (moody)

Vaginal atrophy,dyspareunia,urge stress incontinence

Osteoporosis , atherosclerosis , Alzheimer’s

Due to decrease oestrogen

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10
Q

Why do women experience hot flushes ?

A

Vascular /vasomotor changes due to decreased oestrogen levels

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11
Q

Why do women experience dysfunctional uterine bleeding at menopause ?

A

Oestrogen level decline but still being produced > so still thickening of endometrium but no ovulation so no corpus luteum > no progesterone so no proper shedding of endometrium > leads to hyperplasia and risk of cancer

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12
Q

What happens to the ovaries and their secretions after menopause ?

A

Atrophy

Decreased oestrogen production but still some androgen (testosterone) production due to high gonadotrophin levels

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13
Q

Why do women get urinary incontinence after menopause ?

A

Oestrogen level decreases : tissue lining urethra and bladder is thinner, less elastic > loss of pelvic tone

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14
Q

What changes occur at the uterus after menopause ?

A

Becomes smaller and fibrotic , regression of myometrium and endometrium , loss of rugae

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15
Q

What effect on bone metabolism does menopause have ?

A

Oestrogen normally inhibits osteoblast activity , so menopause= decrease oestrogen = increased osteoblast activity which leads to osteoporosis

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16
Q

Why are post menopausal women at risk of cvs diseases ?

A

Changes in metabolism lead to hyperlipidemia, increased BP , increase weight and fat distribution more central , insulin resistance increases

17
Q

What treatments can be used to help managing symptoms of menopause?

A
  • dress lighter,avoid caffeine, alcohol
  • change in diet and exercise
  • HRT , mimic female hormones so minimise symptoms, can limit osteoporosis