Menopause Flashcards
What is the average age for menopause in smokers and non-smokers?
Smokers: 50 years.
Non-smokers: 52 years.
What is considered normal age range for menopause?
45-55 years.
What is climacterium?
The period a few years before and after menopause. When the function of the ovaries are decreasing
Describe the physiology behind menopause in short.
Before menopause anovulation is common. No ovulation cause a lack of corpus luteum (hence a lack of progesterone). Thereafter also estrogen levels decrease. When estrogen is too low to stimulate the endometrium, the menopause occurs.
What are symptoms of menopause?
The variation in symptoms is large.
Hot flashes, night sweats, sleeping problems.
Vaginal dryness, soreness and dyspareunia.
Urine leakage, urinary tract infections, prolapse.
Irritability, depressed mood, anxiety.
Decreased sexual desire.
Long-term effects include osteoporosis.
How is menopause diagnosed?
The diagnose is often clear from the patient’s history. (Assessed retrospectively after 12 months of amenorrhea.)
Measurement of hormones are not needed
but may confirm the diagnosis. (High serum FSH and LH, low estradiol. Normal TSH and fT4.)
What are indications for hormone replacement therapy in postmenopausal women?
Severe symptoms. Early menopause (age < 45 years).
What are benefits of hormone replacement therapy for menopausal women?
Efficiently reduces severe symptoms such as hot flashes, night sweats and vaginal dryness.
Reduces the risk for fragility fracture (osteoporosis).
Reduces the risk of bowel cancer.
What are risk associated with hormone replacement therapy for postmenopausal women?
Increases the risk for venous thromboembolism (VTE) and stroke.
Increases the risk for breast cancer (combined therapy).
What are contraindication for hormone replacement therapy in postmenopausal women?
Coronary heart disease. Stroke. History of DVT. Thrombophilia. Endometrial cancer. Breast cancer.
How long is the duration short term hormone replacement therapy in menopausal women?
6 month - 5 years.
What is implied by a T-score of -1 til -2,5?
Osteopenia.
What is implied by a T-score < -2,5?
Osteoporosis.
True or false: At menopause bone remodellering rate decreases, resorption increases, formation decreases and bone is lost.
False. At menopause bone remodellering rate increases, resorption increases, formation decreases and bone is lost.
What are the primary drugs against osteoporosis?
Bisphosphonates, e.g. alendronate (p.o.).
