Menopause Flashcards
what is the average age of menopause?
51 years
what is defined as early, premature and late menopause?
early = <45 premature = <40 late = >54
what type of cells secrete oestrogens?
granulosa
what are the effects of oestrogen on body?
secondary sexual characteristics hair distribution, body shape effect on collagen bone growth proliferates endometrium
how is menopause diagnosed?
vasomotor symptoms
pattern of periods
blood tests?
FSH and LH are released in a pulsatile fashion so a single raised level does not confirm menopause - when are other circumstances that FSH and LH would be raised?
just prior to ovulation
stopping COCP or depoprovera
breastfeeding or certain meds (SSRIs)
what are the physical symptoms of menopause?
hot flushes night sweats palpitations insomnia joint aches headaches
how long does hot flushes usually last?
on average = 2 years
*last 3-5mins
10% = 15 years
what psychological symptoms are associated with menopause?
mood swings irritability anxiety difficulty concentrating forgetfulness
what sexual symptoms are associated with menopause?
vaginal dryness
libido
what are later symptoms of menopause?
frequency recurrent UTIs dysuria incontinence dry hair and skin atrophy of breast and genitals
how is menopause conservatively managed?
diet weight loss exercise lifestyle caffeine CBT mindfulness
how is menorrhagia managed during menopause?
mefenamic acid tranexamic acid progesterones intra-uterine system endometrial ablation hysterectomy
what different types of hormone replacement therapy are available in menopause?
oestrogen alone
oestrogen and progesterone
topical or oral
what are contra-indications for HRT?
breast feeding undiagnosed abnormal vaginal bleeding endometrial cancer pregnancy active thrombo-embolic disorder recent MI active liver disease with abnormal LFT porphyria cutanea tarda
what are the benefits of HRT?
symptom control
quality of life
reduced osteoporotic fracture
reduced bowel cancer
possibly protective for alzheimers & parkinsons
HRT <10years after menopause fewer risks and less CV events
what are the risks of HRT?
VTE CVA breast cancer gallbladder disease HRT >20 years after menopause greater risk of harm
there is no increased cardiac risk if HRT is started before what age?
60
which HRT is associated with no or reduced risk of coronary heart disease?
oestrogen alone = no, or reduced, risk
oestrogen and progesterone = little or no increase in risk
what type of HRT administration is more associated with cerebrovascular accident?
oral > transdermal
which non HRT medications can be used for menopause?
clonidine SSRIs regelle YES Sylk
