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1. Reproduction > Menopause > Flashcards

Menopause Flashcards

1
Q

What is the average age to go through menopause?

A

51

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2
Q

What is termed early menopause?

A

<45 years

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3
Q

What is termed premature menopause?

A

<41 years

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4
Q

Why do you get high FSH in menopause?

A

the oestrogen negative feedback isnt working from the anterior pituitary due to lack of oestrogen

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5
Q

What oestrogenic affects are all lost in menopause?

A 
sexual characteristics
hair distribution, body shape and fat distribution
effect on collagen
bone growth
endometrial proliferation
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6
Q

How does menopause present?

A 
hot flushes - 60-80% of menopausal women, last 3-5 mins
night sweats
palpatations 
insomnia
joint aches
headaches
mood swings
irritibility
anxiety
vaginal dryness
lack of libido
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7
Q

What are the later symptoms of menopause?

A

atrophy of breasts and genitals
dry hair and skin
incontinence and dysuria - due to lack of tissue support
recurrent UTIs

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8
Q

What conservative management can be done for menopause?

A 
weight loss
diet
low caffeine
CBT 
mindfulness 
diet
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9
Q

What is the medical management for menorrhagia?

A

1st line: mefenamic acid and tranexamic acid

2nd line: endometrial ablation and hysterectomy

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10
Q

What is the role of mefenamic acid?

A

reduces prostaglandin synthesis and inhibits binding of prostaglandin E2 to its receptor

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11
Q

What is the role of tranexamic acid?

A

stops clots breaking down

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12
Q

How does oestrogen HRT work?

A

causes a bleed when given at the end of a cycle

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13
Q

Why is oestrogen HRT not normally given?

A

causes endometrial cancer - better to give progesterone too

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14
Q

How does combined HRT work?

A

no bleeding at all

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15
Q

How is HRT given?

A

topical or oral

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16
Q

What is the best possible HRT use?

A

combined topical HRT +/- mirena coil for shortest time possible before age 60

17
Q

What are the contraindications for HRT?

A 
breast cancer
endometrial cancer
recent MI
abnormal LFTs
undiagnosed abnormal vaginal bleeding
active thromboembolic disorder
pregnancy
porphyria cutanea tarda
18
Q

When is HRT most beneficial?

A

<10 yrs after menopause

19
Q

When is HRT most harmful?

A

> 20 years after menopause

20
Q

What are the benefits of HRT?

A

reduced bowel cancer
symtpom control and quality of life
reduced osteoporotic fracture
possibly protective against Alzheimers and Parkinson’s

21
Q

What are the risks of HRT?

A

VTE
breast cancer
gallbladder disease
CVA - only oral

22
Q

What are alternative options to HRT?

A

clomidine - regulates temperature in the hypothalamus
SSRIs - for mood
Regelle, Yes and Sylk - vaginal lubricants

1. Reproduction (50 decks)

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