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EOR GYN > Menopause > Flashcards

Menopause Flashcards

1
Q

menopause

A

cessation of menses >1 yr due to loss of ovarian function

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2
Q

menopause avg age of onset

A

50-52 yrs

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3
Q

why might menopause occur sooner

A

DM
smoker
vegetarian
malnourished

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4
Q

estrogen deficiency changes

A 
vasomotor instability (hot flash)
mood change
osteoporosis 
dyspareunia 
urinary incontinence
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5
Q

atrophic vagintis

A

thin, yellow discharge

vaginal pH >5.5
pruritus

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6
Q

PE of menopause

A

decreased bone density, skin is thin and dry

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7
Q

menopause most sensitive initial test

A

FSH assay

FSH > 30 IU/mL (increased)

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8
Q

menopause labs/hormone levels

A

increased FSH, LH but decreased estrogen (depletion of folicules)

no change in androstenedione

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9
Q

what is the most predominant estrogen after menopause

A

estrone

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10
Q

complications of menopause

A

loss of estrogen’s protective effects = increased osteoporosis, cardiovascular risk and increased lipids

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11
Q

management of hot flashes

A

**estrogen, progesterone ***

clonidine, SSRI, Gabapentin

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12
Q

management of vaginal atrophy

A

estrogen (transdermal or intervaginal)

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13
Q

osteoporosis intervention

A

bisphosponates and SERM (Raloxifene, Tamoxifen)*

weight bearing exercise, calcium, vitamin D, calcitonin

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14
Q

menopause and HRT

estrogen only - benefits

A

most effective symptomatic treatment

transdermal or vaginal > PO

no increased risk of breast cancer

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15
Q

menopause and HRT

estrogen only - risks

A

increased risk of endometrial cancer - better for those with no uterus

thromboembolism (CVA, DVT, PE)

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16
Q

menopause and HRT options

A
  1. estrogen only

2. estrogen and progesterone

17
Q

menopause and HRT

estrogen + progesterone types

A

continuous (same daily dose, doesn’t cause menstrual bleeding)

sequential (cycling) dose change = bleeding possible

18
Q

estrogen + progesterone HRT benefits

A

symptomatic relief, decreased heart, stroke and osteoporosis risk

PROTECTS against endometrial cancer (intact uterus)

19
Q

estrogen + progesterone HRT risk

A

possible increased risk of breast cancer

thromboembolism risk

20
Q

psychological symptoms of menopause

A 
irritability 
anxiety 
depression 
sleep changes
appetite changes
poor concentration 
insomnia
21
Q

physical s/s of menopause

A 
fluid retention (edema, bloating) 
weight gain 
breast pain 
constipation 
back pain 
uterine cramps
22
Q

CI to HRT

A

undiagnosed vaginal bleeding
acute vascular thrombosis
liver disease
history of endometrial or breast cancer

23
Q

holistic substances and menopause

A

soy
black cohosh
ginseng

EOR GYN (3 decks)

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