Menopause Flashcards
cessation of menses for 12 consecutive months…
menopause
patient presents with
- irregular menses
- hot flashes/night sweats
- vaginal dryness
- change to lipids, bone density
perimenopause
FSH > 25 is suggestive of…
perimenopause
perimenopause onset is ___ years before final menstrual period
4
Menopause before ___yo is abnormal
40
FSH > ____ is found in most post-menopausal women
70
Pt. presents with:
- vaginal dryness
- osteoporosis
- CV dz
- Dementia
- Mood sxs
postmenopause
untreated, hotflashes/vasomotor sxs end within how many years of onset?
4-5
straw staging is used for…
menopause tracking
The below can help with what sxs of menopause?
HRT (Most effective)
SSRIs/SNRIs
clonidine
Gabapentin
vasomotor sxs
Estrogen only HRT can be sued for…
hysterectomy
women with an intact uterus can have what HRT
combo estrogen/progestin
women with intact uterus should not use ____ because of the below
endometrial hyperplasia
risk of adenocarcinoma
estrogen only HRT
describe the dosing of HRT
lowest effective dose, shortest duration
Combined HRT confers increased risk for…
VTE and Breast CA
estrogen only HRT confers increased risk of ___ only
VTE
combined HRT decreases risk of…
fracture, colon Ca
the below are C/I for:
- Breast cancer
- Coronary Heart Disease
- Previous venous thromboembolic event or stroke
- Active liver disease
- unexplained vaginal bleeding
- high-risk endometrial cancer
- transient ischemic attack
HRT
is progestin only therapy recommended? why?
no, risk of CA
Testosterone can help with what for post-menopausal women
sexual function
This is the term to describe atrophic sxs from estrogen loss during menopause
genitourinary syndrome of menopause
Patient presents with:
- vaginal drying
- vaginal pruritis
- dyspareunia
- sexual dysfunction
vulvovaginal atrophy
genitourinary syndrome of menopause can present with what two GU sxs?
frequency, recurrent bladder infx
what is local estrogen therapy useful in treating?
vulvovaginal atrophy
The below are risk factors for?
"ACCESS" Alcohol use CS use Calcium low Estrogen low Smoking Sedentary lifestyle
osteoporosis
Two methods of dx for osteoporosis…
DXA scan
Fragility fx
Fx at spine, hip, wrist, humerus, rib or pelvis from standing height or less is suggestive of…
osteoporosis
DEXA scan gives you a ____ score which is the number of SD above or below the mean BMD for sex-matched young normal controls
T score
T score of ____ indicates osteoporosis
-2.5 or less
t score of ______ indicates osteopenia
-1 to -2.5
when should osteoporosis screening occur for normally healthy women?
65
Post menopausal women with the below are considered for____
• Postmenopausal women with a history of hip or vertebral fracture
• Women with a T score ≤ -2.5
• High-risk postmenopausal women with T scores between -1.0 and -
2.5 (based off of FRAX score)
Bisphosphonate tx
2nd line tx for osteoporosis
SERMs (raloxifene)
normal BMD can have repeat scan on what time frame?
5-15 years
T score -1.5 to -1.99 should be re-screened when?
5 years
T score -2 to -2.49 should be rescreened when?
1 year
if on osteoporosis tx, how often should screening occur?
repeat 1-2 years, and every 2 years after
uterovaginal and vaginal vault are what type of pelvic organ prolapse?
apical
cystocele is what type of pelvic organ prolapse?
anterior compartment
rectocele is what type of pelvic organ prolapse?
posterior compartment
A patient presents with:
- Heaviness
- Pressure
- Discomfort
- Urinary Symptoms (Incontinence vs retention)
- Defecatory Symptoms (with posterior defects)
- Splinting
- Pain and irritation
pelvic organ prolapse
two methods of conservative management of pelvic organ prolapse
pessary devices
kegel exercises
a patient who is symptomatic or failed conservative tx
surgery
The below are disadvantages of:
- Odor
- Discharge
- Vaginal ulcerations
- Must remove for coitus
pessaries
Surgical tx of pelvic organ prolapse that provides apical support
sacrospinous fixation
this is the attachment of the vagina/cervix to the anterior longitudinal ligament of the sacrum
sacrocolpopexy
plication to vaginal tissue to the midline to reduce bulging bladder
anterior repair
plication to vaginal tissue to midline to reduce bulging rectum
posterio repair
most POP is not urgent, unless… (2)
urinary retention
obstructive neuropathy
