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3 REPRO > menopause > Flashcards

menopause Flashcards

1
Q

what is the menopause

A

last ever menstrual period

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2
Q

what is the climacteric

A

onset of symptoms of the menopause

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3
Q

when is early menopause

A

<45 years

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4
Q

when is premature menopause

A

<40 years

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5
Q

when is the average onset of menopause

A

51 years

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6
Q

when is late menopause

A

> 54 years

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7
Q

what are the effects of oestrogen

A 
secondary sexual characteristics 
hair distribution, body shape and fat distribution
effects on collagen 
bone growth 
proliferates endometrium
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8
Q

how to diagnose the menopause

A

pattern of periods
symptoms
blood tests if <45 years to exclude other ddx

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9
Q

why should you not check FSH and LH

A

they are pulsatile so are not constant amounts of hormone

when the ovaries stop responding so well to the hormones the amount of hormone increases

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10
Q

what can cause levels of FSH and LH to rise

A

just prior to ovulation
raised with stopping COC pill or depo injection
breastfeeding
medications (e SSRIs)

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11
Q

what are the physical symptoms of the menopause

A 
hot flushes 
night sweats 
palpitations 
insomnia 
joint aches 
headaches
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12
Q

how long do hot flushes normally last

A

2 years

can last up to 15 years

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13
Q

psychological symptoms of the menopause

A 
mood swings 
irritability 
anxiety 
difficulty concentrating 
forgetfulness
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14
Q

sexual symptoms of the menopause

A

vaginal dryness

libido

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15
Q

later symptoms of menopause

A 
frequency 
recurrent UTI
dysuria 
incontinence 
dry hair and skin
atrophy of breasts and genitals
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16
Q

conservative management of menopause

A 
diet (plant oestrogen eg soy products)
weight loss 
exercise 
lifestyle 
caffeine
17
Q

management of menorrhagia

A 
mefenamic acid 
tranexamic acid 
progesterones 
intra-uterine system 
endometrial ablation 
hysterectomy
18
Q

what is mefenamic acid

A

NSAID

reduces blood flow to uterus

19
Q

what is tranexamic acid

A

anti-fibrinolytic

clots dont break down

20
Q

how do progesterones reduce menorrhagia

A

makes body think you are pregnant so doesn’t proliferate the womb so much

21
Q

why should you not give oestrogen only ie give progesterone as well

A

oestrogen only increases the chance of endometrial cancer because of the unopposed proliferation

22
Q

pros of HRT

A

symptoms control
improved quality of life
reduced osteoporotic fracture
reduced bowel cancer
possibly protective against Alzheimer’s and Parkinson’s
HRT <10 years after menopause fewer risks and less CV events

23
Q

cons of HRT

A 
increased risk of VTE
CVA 
breast cancer 
gallbladder disease 
HRT >20 years after the menopause greater risk of harm
24
Q

non-HRT treatment options

A

clonidine
SSRIs
regelle
sylk

3 REPRO (40 decks)

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