Menopause Flashcards
What is menopause
End of menstruation where ovaries produce lower levels of oestrogen and progesterone
Women is no longer able to become pregnent
Is permanent cessation of menstruation due to loss of ovarian follicular activity
Time when no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified
What is the difference between physiological and pathological menopause
Physiological menopause - normal decline in ovarian function due to aging. Begins between 45-55yrs
Pathological menopause - gradual or abrupt cessation of menstruation before 40
Name and describe the stages of menopause
Pre-menopause - time prior to menopause. Changes in menstrual cycle occur. Follicular phase shortens and ovulation becomes early or absent. Have decreased oestrogen, increased FSH and LH. Have decreased fertility but not infertile
Peri-menopause - physiological changes assocaited with end of reproductive capacity. Terminates with completion of menopause
Menopause - permanent cessation of menstruation due to ovarian follicular development failure
Post-menopause - time after which women has experience 12th consecutive month of amenorrhea without period
Name some symptoms of menopause
Itchness/twitchiness in vagina
Dry vagina
Sweating - especially night sweats
Sleepy/insomnia - waking up at night
Bloated
Psychological symptoms - depression, anger, anxiety, moody, forgetful
Hot flushes
Name some early symptoms of menopause
Insomnia
Sweating
Hot flushes - seconds to minutes. Rare or recurrent
Menstrual irregularity
Psychological symptoms
Name some complications that can occur from menopause
Osteoporosis
Atherosclerosis - coronary heart disease, cardiovascular disease
Alzheimer’s disease
Describe the genital changes that occur with menopause
Ovaries become smaller -> decreased oestrogen production. Aromatse in ovaries still converts androgens to oestrogen
Uterus shrinks and becomes fibrotic due to atrophy of muscles - endometrium and myometrium shrink
Cervix shrinks and appears to flush with vagina - thinning of cervix and loss of vaginal rugae
Decreased fat in labia majora and mons pubis
Pubic hair becomes sparse
Thin women’s breasts become flat and shrivelled
Large women’s breasts become flabby and pendulous
Describe the changes in general appearance that occur with menopause
Skin loses elasticity and becomes thin and fine - loss of elastin and collagen
Weight increases with deposition of fat around hips, waist and buttocks
Hair becomes coarse and dry - may have hair loss due to decreased oestrogen
Voice becomes deeper - thickening of vocal cords
Describe the changes to the digestive and urinary systems that occur with menopause
Motor acitivity of GI tract decreases - intestine tends to become sluggish -> constipation
Decreased oestrogen levels causes tissue lining urethra and bladder to become drier, thinner and less elastic -> change in pelvic tone and urinary incontinence
Describe the changes that occur to bone with menopause
Ca loss from bone increases -> have loss of bone density and bones are liable to #
Decreased oestrogen results in enhanced osteoclast ability to absorb bone -> get osteoporosis
What helps prevent osteoporosis in menopause and what increases the risk
Risk increased with obesity
Impact exercise helps prevent as it stimulates osteoblast function (as well as osteoclast) so there is increased osteoblast activity to counter enhanced osteoclast acitivity
Describe the changes to the cardiovascular system that occur with menopause
Changes in lipids: total cholesterol increased, have enhaced LDL oxidation, increased TAGs, decreased HDL
Have increased risk of heart diesase and stroke
Systolic and diastolic pressures increase
Carbohydrate tolerance decreases - insulin resistance increases and insulin sensitivity decreases
What is the non-pharmacological treatment for menopause
Dressing in light layer to alleviate hot flashes and night sweats - also avoid caffeine, alcohol and spicy foods
Reduce dietary fat intake
Regular exercise to combat weight gain and decrease risk of osteoporosis
Ca or bisphosphonates to prevent osteoporosis
What is the pharmacological treatment for menopause and what are its disadvantages
Hormone replacement therapy - oestrogen supplement
Given to women to overcome short and long term consequences of oestrogen deficiency
Can be used before, during or after menopause
Not advised for cardioprotection
Disadvantages: increased risk of breast cancer, clots and endometrial cancer
