Menopause Flashcards
define menopause
last ever period
what is the climacteric?
symptoms associated with the menopause ie hot flushes
when might you get an early menopause?
chemotherapy infection FH ovariectomy POF
average age of menopause?
51 yrs
late menopause is onset at >_years
54
premature menopause is onset at
40
what does oestrogen do?
proliferates endometrium -> periods secondary sexual characteristics hair distribution/body shape/fat distribution effect on collagen bone growth
why dont you check LH and FSH if menopause is suspected?
its released in a pulsatile fashion so a single raised level doesnt confirm menopause
what contraceptives can cause raised LH and FSH when stopped?
COC
depoprovera
what antidepressants can cause increased LH and FSH?
SSRIs
when should you check LH and FSH levels in suspected menopause?
hysterectomy patients
presentation of menopause?
hot flushes night sweats palpitations insomnia joint aches headaches
average time for hot flushes during menopause is _ years
2
duration of hot flushes?
3-5 minutes
psychological symptoms of menopause?
mood swings irritability anxiety difficulty concentrating forgetfulness
sexual symptoms of menopause?
vaginal dryness
libido
why do women get sexual symptoms in menopause
ovaries produce testosterone and this increases libido; decreased collagen from less oestrogen causes vaginal dryness
why do women get more urinary symptoms and UTIs?
collagen lines the bladder neck and is made by oestrogen
later symptoms of menopause?
FUN symptoms dysuria incontinence dry hair/skin atrophy of breast and genitals
Ix perimenopausal dysfunctional uterine bleeding?
biopsy
conservative Tx of menopause
diet - more plant oestrogens weight loss exercise lifestyle remove caffeine
Tx menorrhagia
1. mefenamic acid (NSAID) transexamic acid (anti-fibrinolytic) 2. progesterones (POP, implant, injection) 3. IUS 4. endometrial ablation 5. hysterectomy
when should you take mefenamic and transexamic acid? what do they do?
only take with period, should reduce bleeding by half
Tx vasomotor symptoms
HRT (1st line)
SSRIs
clonidine for hot flushes
lubricants
why do you give both oestrogen and progesterone rather than just oestrogen?
if you continually proliferate the endometrium eg by just oestrogen it can increase endometrial cancer so give progesterone as a protector
who can just take oestrogen as HRT?
hysterectomy patients
HRT only increases risk of heart disease after _ years of taking it
10
benefits of HRT?
symptom control
reduces osteoporotic risk
possibly protects against alzheimers/PD
reduced bowel cancer
risks of HRT?
VTE
CVA
breast cancer
gallbladder disease
clonidine is effective for what menopausal symptoms?
hot flushes
