Menopause Flashcards
When is menopause said to have started?
The day the woman had her last period
What is the average age of menopause in the UK?
51
What age is classified as early menopause?
<45 years old
What age is premature menopause classified as?
<40 years old
What is defined as late menopause?
> 54 years old
How many ova are there at birth?
1 million
What do ova exist as?
Follicles
What hormones encourage granulosa cells to grow?
LH and FSH
Where are LH and FSH secreted from?
Anterior pituitary
What is the function of LH and FSH?
Encourage granulosa cells to grow
What do granulosa cells secrete?
Oestrogen
What cells secrete oestrogen?
Granulosa cells
What is the function of oestrogen during puberty?
Develop secondary sexual characteristics
List some secondary sexual characteristics.
- Hair distribution
- Body shape
- Fat distribution
What tissue type does oestrogen affect?
Collagen
Why does everything become ‘saggy’ after menopause?
Because oestrogen affects collagen but women lose oestrogen in menopause
What hormones cause women to release eggs?
LH and FSH
What does oestrogen do to the endometrium?
Proliferates the endometrium
What 3 things are considered in the diagnosis of menopause?
- Symptoms
- Pattern of periods
- Blood tests
In what fashion is LH and FSH released?
A PULSATILE fashion
Why is LH and FSH difficult to measure in blood tests?
They are released in a pulsatile fashion
** A single raised FSH and LH level does not confirm menopause !! **
True
When do LH and FSH raise naturally?
Prior to ovulation
LH and FSH are raised with stopping combined pill or Depoprovera
TRUE
Why should LF and FSH never ben given to young women?
It could induce menopause
What medication can raise LH and FSH?
SSRI’s
Why do LH and FSH raise after menopause?
Telling ovaries to release an egg but ovaries aren’t listening as well during menopause so they have to shout louder
List some common symptoms of the menopause.
- Hot flushes
- Night sweats
- Palpitations
- Insomnia
- Joint aches
- Headaches
Hot flushes are a _________ symptom
Vasomotor
What % of menopausal women get hot flushes?
60-80%
How long does each hot flush last?
3-5 mins
How long does the period of hot flushes last?
2 years
What % of people have hot flushes for 15 years?
10%
List some psychological symptoms of menopause.
- Mood swings
- Irritability
- Anxiety
- Difficulty concentrating
- Forgetfulness
Why (later in menopause) do bladder symptoms occur?
Due to loss of bladder support from lack of collagen and oestrogen
List some of the bladder symptoms that occur after menopause.
- Frequency
- Recurrent UTIs
- Dysuria
- Incontinence
List 2 later symptoms of menopause.
- Dry hair and skin
* Atrophy of breast and genitals
List 2 sexual symptoms of menopause. Why do these happen?
- Vaginal dryness
- Lack of libido
Oestrogen changes collagen, decreased collagen vaginal dryness and worse sex and more common UTI’s, incontinence etc
What 2 hormones do the ovaries produce?
Oestrogen and testosterone
What hormone affects libido?
Testosterone
Name the 3 different categories of perimenopausal dysfunctional uterine bleeding.
- Irregular periods
- Intra-menstrual bleeding
- Post menopausal bleeding
Oestrogen causes the lining of the womb (endometrium) to ___________
Proliferate
List some conservative management options of the menopause.
- Diet – vital oestrogens from plants e.g soy is good !!
- Weight loss
- Exercise
- Lifestyle
- Caffeine
List some conservative management options of the menopause.
- Diet – vital oestrogens from plants e.g soy is good !!
- Weight loss
- Exercise
- Lifestyle
- Caffeine reduction
List the different management options of menorrhagia.
- Mefenamic acid – an NSAID which works by reducing blood supply to womb.
- Tanexamic acid – an anti-fibrinolytic, less clotting
Both above ones reduce bleeding by ½ and you only need to take with your period
- Progesterones – the reason they’re having bleeding is due to the action of unopposed oestrogen i.e telling womb that you are pregnant, so it doesn’t proliferate lining of womb and less bleeding
- Intra-uterine system – give progesterone to oppose action of oestrogen.
- Endometrial ablation – scar the endometrium so it can’t proliferate
- Hysterectomy
HRT can be oestrogen only or oestrogen + progesterone
True
How can HRT be given?
Topical or oral
List the benefits of HRT.
- Symptom control
- Improved quality of life
- Reduced osteoporotic fractures
- Reduced bowel cancer
- Possibly protective against Alzheimer’s and Parkinson’s diseases
List the risks of HRT.
- VTE – 2 to 7 extra per 1000
- CVA
- Breast cancer – 6 extra per 1000
- Gallbladder disease
An a-2-adrenergic agonist for which there is some evidence for use in the treatment of vasomotor symptoms
Clodinine
Regelles is a?
A vaginal moisturiser
Yes is a?
Lubricant
Sylk is a?
Lubricant
