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Reproductive System > Menopause > Flashcards

Menopause Flashcards

1
Q

Define menopause

Describe the follicles and oestrogen and progesterone levels

A

Permanent cessation of menstruation for 12 consecutive months, with no other biological/ physiological cause

No primary follicles left, oestrogen and progesterone levels decline

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2
Q

What is the average age of menopause and usual age range?

An abrupt cessation of menstruation below what age should be investigated?

A
  • Average age: 50
  • Age range: 45-55

Below 40 (Premature menopause, usually pathological)

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3
Q

What are the 4 stages of Menopause

Compare the ages of Physiological and Pathological menopause

A
  1. Pre-menopause
  2. Peri-menopause
  3. Menopause
  4. Post-menopause

Physiological: 45-55
Pathological : <40

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4
Q

Describe Pre-Menopause (Initial changes of a menstrual cycle)

A
  • Cycle often shortens, ovulation either early/ absent -> Fertility problems
  • Fall in oestrogen -> LH and FSH rise due to lack of negative feedback
  • FSH rises more than LH due to removal of Inhibin
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5
Q

Describe Peri-Menopause/ Transition phase/ Climacteric

A
  • Mood swings and hot flushes
  • Follicular phase shortens
  • Greater infrequency of menstruation
  • Terminates with completion of menopause
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6
Q

Describe Menopause (Stage 3)

A

When there has been complete cessation of menstruation for 12 months

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7
Q

Define Post-Menopause

A
  • Time after which a woman has experienced 12 months of amenorrhea
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8
Q

Can a woman become pregnant in the Pre and Peri menopausal stages

A

Yes (However quality of oocytes starts to decline after puberty and into reproductive life)

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9
Q

Most symptoms of menopause are related to oestrogen deficiency.

What are the 3 classes of symptoms

A
  • Early stages of menopause
  • Intermediate stages of menopause
  • Late stages of menopause
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10
Q

Which hormone is measured to diagnose physiological menopause?

A

FSH

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11
Q

What are 5 symptoms of the Early stages of menopause

A
  • Hot flushes
  • Sweating
  • Insomnia
  • Mood swings/ depression
  • Irregular menstruation (amount of blood, cycle length)
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12
Q

What are 4 PHYSIOLOGICAL symptoms of the Intermediate stages of menopause

A

Due to further decreasing levels of oestrogen;

  • Vaginal atrophy-> Dyspareunia
  • Skin atrophy (Less toned, less radiant)
  • Stress incontinence
  • Increased UTI frequency
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13
Q

What are 5 PHYSICAL symptoms of the Intermediate stages of menopause

A
  • Ovarian atrophy, Uterus thinning, Loss of vaginal Rugae
  • Reduced pubic hair (less testosterone)
  • Breast tissue size/shape change
  • Changes to hair/ voice/ bloating/ fat storage
  • Constipation
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14
Q

What do you investigate for in a post-menopausal patient who comes in with bleeding?

Why?

A

Endometrial carcinoma

No corpus Luteum-> No progesterone made-> Unopposed oestrogen (Which is responsible for the Proliferative phase, so bleeding should not occur)

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15
Q

What are 4 symptoms of the Late stages of menopause

A
  • Oestoporosis
  • Link with Alzheimer’s
  • Increased atherosclerosis
  • Coronary heart/ Cardiovascular disease
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16
Q

Why does going through menopause result in osteoporosis?

What are 2 things this can lead to?

A
  • Oestrogen inhibits osteoclasts
  • Oestrogen levels decrease-> Increased bone resorption and Ca loss from bone
  • Can cause pathological fractures (Neck of femur)
  • Skeletal structure changes (Reduced height) due to reduced bone mass
17
Q

Why does going thorough menopause increase risk of cardiovascular disease?

A
  • Low levels of oestrogen and progesterone lead to changes in fat storage
  • Leads to hypercholesterolaemia/ hyperlipidaemia, increasing risk of Atherosclerosis, MI and Stroke
18
Q

Some women are able to manage the symptoms of menopause on their own.

Some need supportive management. What are the 2 types

A

Hormonal and non-hormonal

19
Q

Describe non-hormonal management of menopause

A
  • General lifestyle advice to help with vasomotor symptoms (GI, Sweat, Hot flushes)
  • Dietary advice to reduce wight gain and cardiovascular risk
20
Q

Describe hormonal management of menopause

A

HRT: Involves replacing oestrogen either;

  • Locally (e.g cream for vaginal atrophy)
  • Orally
  • Transdermal (patch)

Reproductive System (21 decks)

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