Menopause

Question 1

define the menopause

Answer 1

last menstrual period, must have had amenorrhoea for 1 year

Question 2

what is the average age of the menopause

Answer 2

52, anything between 46-55 is normal

Question 3

outline the pathophysiology of the menopause

Answer 3

ovaries become less responsive to LH/FSH in the menopause, therefore LH and FSH rise just before the menopause

Question 4

outline some of the acute/immediate effects of the menopause

Answer 4

vasomotor - hot flushes
headache
fatigue
insomnia
dizziness 
poor memory/reduced concentration 
reduced libido

Question 5

outline some of the medium term effects of the menopause

Answer 5

vaginal - dry, burning, dysparenunia, prolapse
general - dry skin and hair thinning
urinary - stress and urge incontinence, increased frequency

Question 6

outline some of the long term effects of the menopause

Answer 6

cardiovascular and cerebrovascular as oestrogen lowers LDL

osteoporosis

Question 7

what are the 2 broad management options for the menopause

Answer 7

lifestyle measure

oestrogen therapies

Question 8

what lifestyle measures are beneficial in the menopause

Answer 8

healthy diet
regular exercise
stopping smoking

Question 9

what are the options of HRT

Answer 9

oestrogen only
combined HRT
sequential for perimenopausal
continuous

Question 10

what is the maximum duration of sequential HRT for perimenopausal women

Answer 10

5 years due to endometrial cancer risk

Question 11

list some of the benefits of HRT

Answer 11

relieves vasomotor symptoms
reduces colorectal cancer and osteoporosis risk
symptoms may recur after stopping

Question 12

list some of the risks of HRT

Answer 12

increases risk of breast cancer
oral HRT increases risk of VTE
stroke
increased risk of endometrial cancer - sequential therapy only