Menopause Flashcards
State 5 causes of premature menopause
- Chromosomal abnormality (e.g. turner’s syndrome or fragile X
- Autoimmine disorder
- Infection
- Surgery
- Consequence of cancer treatment
Diagnosis of menopause
Is based on symptoms and menstrual irregularities
What tests can support menopause diagnosis
- FSH/LH/Oestradiol (repeated 6 weeks apart)
2. Thyroid function tests
How is menopause treated?
Hormone replacement therapy (HRT)
What 3 things can test ovarian reserve?
3D ultrasound to measure number of eggs
FSH measurements
Anti-mullerian hormone (Most accurate)
Explain the compositions of FSH, LH and oestrogen post-menopause
Hypothalamus still causes release of GnRH so anterior pituitary releases FSH. However no eggs so no feedback via oestrogen so FSH and LH rises and oestrogen levels decrease.
Describe the mechanism of action of HRT
It is a steroid hormone that can bind to either Oestrogen receptor alpha or beta. 1. Hormone diffuses into cytoplasm 2. Binds to receptor 3. Translocated to nucleus 4. Alters gene transcription 5. Creates new mRNA 6 Translation of new proteins
How does the presence of a uterus affect HRT?
Without a uterus HRT is just oestrogen (orally)
With uterus HRT is oestrogen and progesterone
Describe continuous HRT and who is it appropriate for?
Oestrogen and progesterone given daily with out a break (post-menopausal)
Describe sequential HRT and who it is appropriate for
Continuous oestrogen but sequential progesterone (recommended for peri-menopausal)
Describe testosterone as a treatment for menopause
Improves symptoms of libido, energy, mood, concentration (given as gel, patch or implant)
List 5 symptoms of HRT from oestrogen
Fluid retention, nausea, headaches, breast tenderness, leg cramps
List 4 symptoms of HRT from progesterone
- Irregular bleeding
- PMS
- Bloating
- Depression
List 4 ways to reduce side-effects of HRT
- Reduce dose
- Take with food
- Change type of hormone
- Change route of administration
State 5 HRT alternatives
- Selective oestrogen receptor modulator
- Selective serotonin reuptake inhibitors (SSRI) low dose
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) low dose
- Antihypertensives (alpha agonists)
- Antiepileptic