menopause Flashcards
when do you begin screening women for osteoporosis
healthy women by age 65
earlier if women smoke, drink, RA, hx of fractures, dz/meds that add to the risk, body weight less than 127
combo estrogen and progestin Hormone Therapy
increases risk of
but decreases risk of
increases risk of:
- thromboembolic events
- breast CA
- CVD
- stroke
decreases risk of
- fractures
- colon CA
what are some non-pharmacologic osteoporosis preventative measures that pts can take
exercise: weight bearing, resistance, walking, aerobics
nutrition:
increase Ca to 1200 mg/ day at age 50
increase Vit D to 800 at age 70
avoid:
smoking, ETOH
laboratory diagnosis of perimenopause
FSH > 25
what are the non-hormonal pharmacological treatments for the vasomotor sxs of perimenopause and menopause
SSRIs (esp. LD paroxetine)
SNRIs
centrally acting anti-epileptics (gabapentin, pregabalin, clonidine)
vaginal vault apical pelvic prolapse
enterocele
stage 1 pelvic organ prolapse
more than 1 cm from the hymenal ring (inside)
Hispanic women are more susceptible to ___
pelvic organ prolapse
stage 3 pelvic organ prolapse
beyond 1 cm past the hymenal ring but still in vagina
what type of hormone therapy do you give
to a woman who has
undergone a hysterectomy
estrogen only
posterior compartment pelvic prolapse
rectocele
why is progestin added to estrogen in Hormone Therapy for women with a uterus
to decrease the risk of endometrial hyperplasia and endometrial CA
what type of hormone therapy do you give
to a woman who
still has an intact uterus
combo estrogen and progestin
(b/c unopposed estrogen with a uterus can cause endometrial hyperplasia and increase the risk of endometrial CA)
what are the components of the genitourinary syndrome of menopause
vulvovaginal atrophy (dryness, itching, dyspareunia)
sexual dysfunction
urinary frequency
recurrent bladder infections
white women and menopausal side effects
more susceptible to ___
osteoporosis
DEXA T score’s:
normal
osteopenia
osteoporosis
normal = - 1 +
osteopenia = - 1 to - 2.5
osteoporosis = less than - 2.5
when treating a patient w/ systemic hormone therapy,
what should the dose be?
for how long should they take it?
lowest effective dose
for the shorterst duration needed
(generally not more than 5 years or beyond 60)
