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1. Foundations III > Menopause > Flashcards

Menopause Flashcards

1
Q

Climacteric

A

Phase in a woman’s reproductive life when a gradual decline ovarian fxn results in decreased sex steroid production, and the associate sequelae

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2
Q

Menopause transition

A

change in length
increase FSH
leading to FMP

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3
Q

Perimenopause

A

change in length
increase FSH
12 months after FMP

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4
Q

Menopause

A

12 months of amenorrhea after FMP in a woman >45 yo in absence of other biological/physiological causes

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5
Q

Postmenopause

A

early stage is first 5 yrs after FMP, late stage is 5 yrs after FMP to death

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6
Q

Nl age of menopause and contributing factors to age of onset

A

50-55, avg 51.5

-genetics, smoking, hysterectomy

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7
Q

Sx of perimenopause

A
  • changes in menstrual cycles
  • mood and emotional changes
  • hot flashes or flushes and night sweats
  • breast changes
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8
Q

What happens to estrogen, androgens, progesterone, LH, and FSH levels in menopause?

A
  • decreased estrogen
  • decreased androgens (facial hair growth, decreased breast size)
  • decreased progesterone (irregular vaginal bleeding)

-Increased LH and FSH

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9
Q

General sx of menopause

A
  • hot flushes
  • insomnia
  • irritability
  • mood disturbances
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10
Q

physical changes of menopause

A
  • urogenital atrophy
  • urinary stress incontinence
  • skin collagen loss
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11
Q

disease a/w menopause

A
  • osteoporosis
  • CV disease
  • dementia
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12
Q

Describe sx of “genitourinary syndrome of menopause”

A
  • vaginal atrophy
  • vaginal canal shrinks in diameter
  • elastic capacity of the bladder is decreased
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13
Q

What are 1st and 2nd line tx options for menopause?

A

1ST line= non-hormonal vaginal moisturizers and lubricants

2nd= vaginal estrogen therapy

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14
Q

What is the gold standard tx for patients for relief of vasomotor sx?

A

Estrogen therapy

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15
Q

Who should NOT have unopposed estrogen?

A

women w/ a uterus

also: breast CA, CHD, prior stroke, high risk endometrial CA

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16
Q

When prescribing Menopause Hormone Therapy (MHT), what dosage/time do you do?

A

lowest effective dose for the shortest period of time (<5 yrs)

17
Q

What are adverse effects of long-term, high dose Menopause Hormone Therapy?

A

Increased risk of CHD, stroke, VTE, breast CA

18
Q

True or false: MHT should be used for prevention of chronic diseases (CHD, osteoporosis)

A

NAHHHHH

19
Q

Alternative tx:

Soy & isoflavones can be used for?

A

short term tx for vasomotor sx (2 yrs)

20
Q

Alternative tx:

St. John’s wort can be used for?

A

short term tx of mild-mod depression (2yrs)

short term tx of hot flashes (8 wks)

21
Q

Alternative tx:

Black cohosh can be used for?

A

short term tx of vasomotor sx (6 mo)

22
Q

What is a cystocele & what is it a/w (higher risk)?

A

downward displacement of bladder into the vagina

a/w childbirth

23
Q

Common sx of a cystocele?

A
  • pelvic pressure
  • low back pain
  • sensation of “sitting on something”
24
Q

Aggravating and Alleviating factors of cystocele

A

aggravating= vallava, cough, sneeze

alleviating= lying supine

25
Q

How do you dx a cystocele?

A

Clinically

you’ll see it coming out of the vagina…

26
Q

Non surgical options for cystocele

A
  • exercises- kegels
  • pessary use
  • vaginal weights
27
Q

Surgical intervention of choice for cystocele?

A

anterior colporrhaphy

bladder is pushed back into place &support tissue is tightened/reinforced

28
Q

What is a rectocele?

A

rectovaginal herniation between the rectum and the vagina

29
Q

Possible sx of rectocele?

A
  • rectal fullness
  • straining at stool
  • vaginal “bulging”
  • low back pain
30
Q

What type of patients would you use non-surgical management of a rectocele for?
what are the options

A
  • pts w/ want more kids
  • asymptomatic pts
  • stool softeners
  • kegel exercises
  • pessary
31
Q

What is the surgical management done for rectocele?

A

colpoperineorraphy

sutures placed in levator ani muscles

32
Q

Vaginal prolapse typically is seen after what?

A

hysterectomy

33
Q

Sx of vaginal prolapse

A
  • pelvic pressure
  • sensation of bearing down
  • dyspareunia
  • low back pain
34
Q

If pt is not longer sexually active, what are the surgical interventions done for vaginal prolapse? (2)

A

colpectomy and colpocleisis

closing the vagina off

35
Q

If pt desires sexual activity, what surgical option is done for vaginal prolapse?

A

vaginal suspension

1. Foundations III (20 decks)

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