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Y3 OBS AND GYNAE > Menopause > Flashcards

Menopause Flashcards

1
Q

What is menopause?

A

A woman’s last ever menstrual period

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2
Q

What is the climacteric period?

A

Time leading up to menopause when symptoms appear

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3
Q

What is average age for menopause to occur?

A

51 years old

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4
Q

When is menopause considered premature?

A

If it occurs before the age of 40

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5
Q

When is menopause considered late?

A

If it occurs after the age of 54

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6
Q

When is menopause considered early?

A

If it occurs before the age of 45

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7
Q

Absence of what hormone causes the menopause?

A

Oestrogens

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8
Q

What cells secrete oestrogen?

A

Granulosa cells

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9
Q

Which sex harmones control the release of oestrogen?

A

FSH and LH from the anterior pituitary

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10
Q

State the physiological effects of oestrogen on the body

A 
Secondary sexual characteristics
Hair distribution
Body shape
Fat distribution
Prevents reduction in collagen
Bone growth
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11
Q

What effect does oestrogen have on the endometrium?

A

Proliferates and thickens the endometrium

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12
Q

List diagnostic options for menopause

A

Symptoms
Pattern of periods
Blood tests in women under 45yo or hysterectomy

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13
Q

How are blood tests used to diagnose menopause?

A

FSH and LH levels taken twice two weeks apart

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14
Q

What happens to FSH and LH levels following menopause?

A

They increase as there is no oestrogen to negatively feedback to inhibit release

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15
Q

List some physical symptoms of menopause

A 
Hot flushes (very common)
Night sweats
Palpitations
Insomnia
Joint aches
Headaches
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16
Q

List some psychological symptoms of menopause

A 
Mood swings
Irritability
Anxiety
Difficulty concentrating
Forgetfulness
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17
Q

List some sexual symptoms of menopause

A

Vaginal dryness

Libido loss

18
Q

List some late-on features of menopause

A 
Frequency
Recurrent UTIs
Dysuria
Incontinence
Dry hair and skin
Atrophy of breasts and genitals
19
Q

State the types of perimenopausal dysfunctional uterine bleeding

A

Irregular periods
Intramenstrual bleeding
Post-menopausal bleeding

20
Q

Why does perimenopausal bleeding occur?

A

Excess unopposed oestrogen without enough progesterone (no ovulation)

21
Q

List common causes of post-menopausal bleeding

A

Atrophic vaginitis
Cervical polyps
Endometrial hyperplasia
Endometrial cancer

22
Q

When is bleeding following menopause considered post-menopausal bleeding?

A

After 1 year of having menopause

23
Q

Outline conservative management options for menopause

A 
Diet (soy)
Weight loss
Exercise
Lifestyle
Caffeine 
Alcohol
24
Q

Which NSAID can be given for post-menopausal bleeding? How does it help?

A

Mefenamic acid

Reduces blood supply to uterus to minimise bleeding

25
Q

Which antifibrinolytic can be given for post-menopausal bleeding? How does it help?

A

Tranexamic acid

Delays clot breakdown

26
Q

Why could progesterone agents be given for post-menopausal bleeding?

A

Stabilise womb lining and make it less likely to proliferate

27
Q

What treatment offers endometrial protection for up to 4 years against menorrhagia?

A

Intra-uterine system (releases low-dose progesterone)

28
Q

List management options for menorrhagia

A 
Mefenamic acid
Tranexamic acid
Progesterone
Intra-uterine system
Endometrial ablation
Hysterectomy
29
Q

What symptoms does HRT help treat?

A

Vasomotor symptoms (hot flushes/night sweats).
Mood swings.
Vaginal and bladder symptoms

30
Q

Which harmones are typically given in HRT? Which routes of administration can be used?

A

Progesterone and oestrogen

Topical, oral

31
Q

List some benefits of HRT

A 
Symptom control
Reduces risk of osteoporotic fracture
Reduces risk of bowel cancer
Possibly protective against AD and PD
Possibly less cardiovascular events
32
Q

List some risks of HRT

A

VTE
CVA
Breast cancer
Gallbladder disease

33
Q

In what situations, should HRT be avoided?

A

Patient is at risk of breast cancer

Patient is at risk of VTE

34
Q

Which antihypertensive can be used for management of menopause?

A

Clonidine

35
Q

Which class of antidepressants can be used for management of menopause?

A

`SSRIs

36
Q

Which moisturisers or lubricants can be used for management of menopause?

A

Regelle
Yes
Sylk

37
Q

State an absolute contraindication to HRT

A

Active or recent arterial thromboembolic disease

38
Q

In woman with a uterus or with a partial hysterectomy offer…

A

Combined (oestradiol plus progestogen) HRT preparation

39
Q

In women with a full hysterectomy offer…

A

Oestrogen-only preparation

40
Q

In women diagnosed with premature menopause offer…

A

Sex steroid replacement with a choice of HRT or a combined oral contraceptive (unless contraindicated, for example in women with hormone-sensitive cancer)

Y3 OBS AND GYNAE (44 decks)

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