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Midwifery > Menopause > Flashcards

Menopause Flashcards

1
Q

What is the definition of menopause?

A

12 consecutive months without a period

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2
Q

What is the average age of menopause?

A

52

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3
Q

What is the definition of premature menopause?

A

Cessation of ovulation/menses <40 years old, either spontaneous or induced

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4
Q

What laboratory findings are associated with menopause?

A

FSH >40
LH 20-100
E2- <20pg/mL

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5
Q

What happens to bone integrity post-menopause and why?

A

Increased bone loss associated with decreased estrogen

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6
Q

What happens to vaginal pH after menopause?

A

Due to decrease in estrogen and change in vaginal microbes, pH becomes alkaline >5.0

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7
Q

At what age is it appropriate to stop paps if the most recent test was within 5 years and all have been negative in the last 10 years?

A

65 years old

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8
Q

If there is a history of CIN-2 or higher, how long should you continue screening?

A

20 years after spontaneous regression or appropriate management

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9
Q

When are vasomotor symptoms most frequent and severe?

A

the first two years after the final menstrual period

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10
Q

How long do vasomotor symptoms usually last?

A

Typically 5-7 years but may continue longer than 10-15 years

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11
Q

What are some proven non-pharmacologic ways to manage mild/moderate vasomotor symptoms?

A

Cognitive behavioral therapy and clinical hypnosis

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12
Q

Is estrogen therapy (ET) only for a woman with or without a uterus?

A

Unopposed estrogen is for an individual without a uterus

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13
Q

What is the main point of progesterone in estrogen progesterone therapy (EPT)?

A

To reduce the risk of endometrial cancer in women with a uterus associated with unopposed estrogen

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14
Q

What is the only FDA approved human estrogen available?

A

17B-estradiol

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15
Q

What does SERM or ERAA stand for and what is it?

A

SERM- Selective estrogen receptor modulators
ERAA- Estrogen receptor agonists/antagonists
It is an estrogen like compound that acts as an estrogen agonist or antagonist depending on the SERM and target tissue

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16
Q

What is CEE?

A

Conjugated equine estrogen.

Mixture of estrogens isolated from urine of pregnant mares

17
Q

What is BZA and what is it used for?

A

Bazedoxifene is a SERM with estrogen antagonist effects on endometrial and breast tissue and estrogen agonist on bone.
Often used with CEE as an alternative to adding a progestogen to prevent endometrial hyperplasia

18
Q

CEE combined with medroxyprogesterone acetate (MPA) does what compared to BZA/CEE use?

A

Less unscheduled uterine bleeding and less breast tenderness and similar prevention of bone loss, vasomotor symptoms and vulvovaginal atrophy

19
Q

Bio-identical hormones are chemically identical to hormones produced during what phase of a woman’s life?

A

Reproductive

20
Q

How does oral estrogen therapy alone affect CV markers such as HDL-C and LDL-C?

A

positively, by increasing HDL-C and decreasing LDL-C

21
Q

How does oral estrogen therapy alone affect CV markers such as triglycerides and c-reactive protein levels?

A

negatively, by increasing triglycerides and CRP levels

22
Q

What is continuous cyclic EPT and is there a withdrawal bleed?

A

Estrogen everyday with progestogen added 12-14 days monthly.
Withdrawal bleed when progestogen withdrawn each month

23
Q

What is continuous combined EPT and how does it affect bleeding?

A

Estrogen and low dose progestogen everyday.

Unpredictable bleeding at first, then usually the women has amenorrhea

24
Q

What are some side effects of HT related to estrogen?

A

breast tenderness (subsides after a few weeks), nausea, fluid retention and bloating

25
Q

What are some side effects of HT related to progestogen?

A

breast tenderness (subsides after a few weeks), fluid retention and bloating, alterations in mood

26
Q

What is the only non hormonal pharmacologic method approved by the FDA for vasomotor symptoms?

A

Paxil 7.5mg daily at bedtime

27
Q

What symptoms are associated with GSM?

A

Genital dryness/burning/irritation
Sexual symptoms- lack of lubrication/discomfort/impaired function
Urinary symptoms- nocturia, urgency, dysuria and recurrent UTIs

28
Q

Which two drugs aid with dyspareunia associated with GSM?

A

Ospemifine and Prasterone

29
Q

What do the studies show about HT and dementia?

A

Relationship is inconclusive.

But, there is a small increase if EPT is initiated in individuals older >65

Midwifery (10 decks)

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