Menopause Flashcards
1
Q
What is menopause?
A
- last ever period
- average age 51 (< 40 years- premature)
- perimenopause for approx 5 years before
2
Q
What causes menopause?
A
- ovarian insufficiency
- oestradiol falls
- FSH rises
- still some oestriol from peripheral
- conversion of adrenal androgens in fat
- natural/oophorectomy/chemotherapy/radiotherapy
3
Q
What are the symtpoms of menopause?
A
- vasomotor ‘hot flushes’
- 80% women
- last 2-5 years OR 10+ years
- vaginal dryness/dyspareunia
- low libido
- muscle and joint aches
- mood changes
- poor memory
4
Q
What are the FRAX score risk factors for osteoporosis caused by menopause?
A
- thin
- caucasian
- smoker
- EtOH
- +ve FH
- amenorrhoea
- malabsorbtion
- steroids
- hyperthyroid
5
Q
What is the prevention/treatment for osteoporosis caused by menopause?
A
- exercise
- adequate calcium + vit D
- HRT
- biphosphonates
- denosumab- monoclonal antibody to osteoclasts
- teriparatide
6
Q
What is the treatment for the symptoms of menopause?
A
- systemic HRT (transdermic patch/gel/oral)
- oestrogen + progesterone (prevent endometrial hyperplasia) (*also MIRENA)
- oestrogen only- if no uterus
- local HRT (pessary/ring/cream)
- oestrogen only
- Selective Estrogen Receptor Modulators (SERMs)
- SSRI/SNRI antidepressants
- natural methods (e.g. phyooestrogens, CBT)
- non-hormonal vaginal lubricants
7
Q
What are the contraindications for systemic HRT?
A
- current hormone dependant cancer breast/endometrium
- current active liver disease
- uninvestigated abnormal bleeding
- previous VTE, thrombophilia, FH VTE
- previous CA breast or BRCA carrier
