Menopause Flashcards
when has a woman reached menopause
when she has been amenorrhoeic for 12 months
menopause is a retrospective diagnosis, true or false
TRUE
What precedes menopause
peri-menopause / climacteric period
What is the average age of menopause
51 yr
When is early menopause
<45 yr
When is premature menopause
<40 yr
When is late menopause
> 54 yr
What causes menopause
Depletion of ovarian follicles resulting in a decrease in oestrogen levels
What happens to FSH + LH levels as oestrogen decreases
They increase (in an attempt to complete negative feedback)
What are the other effects of oestrogen
2ndary sexual characteristic development hair and fat distribution effect on collagen helps bone growth endometrial proliferation
How is menopause diagnosed normally
based on a woman’s clinical symptoms and age
presence of vasomotor symptoms and irregular periods
When are blood tests used in helping diagnosis and at what times should they be taken
premature menopause
woman with no uterus / endometrial tissue after hysterectomy
atypical symptoms of menopause
2 blood tests 6 weeks apart
Why are FSH + LH levels not routinely checked
because they are released in a pulsatile fashion
they are raised pre ovulation
raised after stopping contraception
single raised levels do NOT confirm menopause
What are the main groups of symptoms a woman experiences in peri-menopause
Physical
Psychological
Sexual
Urinary
What are the physical symptoms of menopause
hot flushes night sweats palpitations insomnia joint aches headaches
What are the psychological symptoms of menopause
mood swings irritability anxiety difficulty concentrating forgetfulness
What are the sexual symptoms of menopause
vaginal dryness
loss of libido
What are the later onset of symptoms in menopause
urinary frequency dysuria recurrent UTIs incontinence dry hair and skin atrophy of breasts and genitals
What are the broad management options for menopause
Conservative
Menorrhagia Mx
HRT
Non-HRT
What are conservative options of management
diet weight loss exercise reduce caffiene CBT mindfulness
What are options for managing menorrhagia
Mefanamic acid - NSAID Tranexamic acid - antifibrinolytic Progestogens Mirena IUS Endometrial ablation Hysterectomy
How can HRT be administered
PO
transdermal patches
Indications for oestrogen only HRT
women with no uterus / endometrial tissue (hysterectomy)
Indications for combined (oestrogen and progestogen) HRT
women with uterus / endometrial tissue present
What is a risk of oestrogen only HRT
unopposed oestrogen causes endometrial proliferation and can lead to hyperplasia and endometrial carcinoma
Which cancer are you at increased risk of if you take combined HRT
breast cancer
What are other risks of taking HRT
VTE PO>transdermal administration
Coronary heart disease and stroke (slight risk)
When is monthly cyclical/sequential HRT given
in women who have regular periods going through peri-menopause
When is 3 monthly cyclical/sequential HRT given
in women with irregular periods through peri-menopause
When is continuous HRT given
Post menopausal women
What are non-HRT options for managing menopause
clomidine
SSRIs
Regelle, Yes, Sylk - vaginal lubricants
