Menopause Flashcards
What type of oestrogen is dominant before menopause?
Estradiol
What type of oestrogen is dominant after menopause?
Oestrone
What does lower levels of estradiol do to the vagina?
Vaginal atrophy
- Decreased secretions
- Decreased elasticity
- Epithelial thinning
- Increased pH
What are the symptoms of vaginal atrophy?
Discharge
Dryness and itching
Dyspareunia
Typical presentation?
” 50 y/o presents with night sweats and difficulty sleeping that she is very worried about. She has also noticed decreased libido and pain when having sex. Her last period was 12 months ago, and she remembers it being noticably light. Vaginal exam shows atrophy and some pallor. “
What are the systemic symptoms of menopause?
Hot flushes and sleep disturbance
Weight gain
Risk of fracture
Irritability
What are the menstrual signs of menopause?
Amenorrhoea
Irregular cycle
What management regimens exist?
HRT
Non HRT
What is the most effective treatment?
HRT
What is standard HRT treatment?
Oestrogens
Medroxyprogesterone acetate (depo-provera)
What is HRT regiment if they have no uterus?
Oestrogen only
What is medroxyprogesterone?
Progestin
- Progesterone receptor agonist
What non-HRT medication can be used for vasomotor symptoms?
SSRI
Venlafaxine
CBT
Bisphosphonates for fracture risk
What can be given for vaginal atrophy?
Topical oestrogens
Lubricant
