Menopause Flashcards
premature menopause is at what age?
under 40
average age of menopause in the UK
51
when is it classed as menopause?
when there has been no periods for at least a year
what happens hormonally in menopause?
oestradiol falls
FSH rises
(ovarian insufficiency)
unnatural ways menopause can occur:
oophorectomy
chemotherapy
radiotherapy
symptoms of menopause
low libido
vasomotor symptoms (hot flushes)
muscle and joint aches
vaginal dryness
mood changes/ poor memory
what condition is the ‘silent change’ associated with menopause?
osteoperosis
how do you treat some of the symptoms of menopause?
HRT (hormone replacement therapy)
SSRI/ SNRI antidepressants
SERMS (selective estrogen receptor modulators)
non-hormonal lubricants
what hormones are in HRT?
oestrogen only if no uterus is present
progesterone and oestrogen if uterus if present
(often youre looking for ovarian function!!)
what are the contraindications for using HRT?
hormone dependent breast cancer
current active liver disease
un-investigated abnormal bleeding
previous VTE
previous breast cancer or BRCA carrier
risk of HRT
breast cancer
ovarian cancer
VTE
fracture femur
colon cancer
woman with no uterus - what HRT?
oestrogen
woman with uterus - but has been in menopause of 5 years - what HRT?
oestrogen
No ovarian function - no need for progestogen endometrial protection
women in perimenopause - the odd period at age 48 - what HRT?
combined (oestrogen and progesterone)
primary amenorrhoea
never had a period
less than 14 - no sexual characteristics
(less than 16 - with sexual characteristics)
secondary amenorrhoea
has had periods in the past but none for 6 months
causes of secondary amenorrhoea
pregnancy/breast feeding
contraception
PCOS
early menopause
thyroid disease/ cushings
raised prolactin
hypothalamic stress
androgen secreting hormone
tests and exams in secondary amenorrhoea
BMI
androgenic signs
urine pregnancy tests - dipsticks for glucose
bloods FSH
pelvic USS
