Menopause Flashcards

1
Q

State 5 causes of premature menopause

A
  1. Chromosomal abnormality (e.g. turner’s syndrome or fragile X
  2. Autoimmine disorder
  3. Infection
  4. Surgery
  5. Consequence of cancer treatment
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2
Q

Diagnosis of menopause

A

Is based on symptoms and menstrual irregularities

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3
Q

What tests can support menopause diagnosis

A
  1. FSH/LH/Oestradiol (repeated 6 weeks apart)

2. Thyroid function tests

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4
Q

How is menopause treated?

A

Hormone replacement therapy (HRT)

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5
Q

What 3 things can test ovarian reserve?

A

3D ultrasound to measure number of eggs
FSH measurements
Anti-mullerian hormone (Most accurate)

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6
Q

Explain the compositions of FSH, LH and oestrogen post-menopause

A

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.

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7
Q

Describe the mechanism of action of HRT

A
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
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8
Q

How does the presence of a uterus affect HRT?

A

Without a uterus HRT is just oestrogen (orally)

With uterus HRT is oestrogen and progesterone

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9
Q

Describe continuous HRT and who is it appropriate for?

A

Oestrogen and progesterone given daily with out a break (post-menopausal)

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10
Q

Describe sequential HRT and who it is appropriate for

A

Continuous oestrogen but sequential progesterone (recommended for peri-menopausal)

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11
Q

Describe testosterone as a treatment for menopause

A

Improves symptoms of libido, energy, mood, concentration (given as gel, patch or implant)

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12
Q

List 5 symptoms of HRT from oestrogen

A

Fluid retention, nausea, headaches, breast tenderness, leg cramps

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13
Q

List 4 symptoms of HRT from progesterone

A
  1. Irregular bleeding
  2. PMS
  3. Bloating
  4. Depression
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14
Q

List 4 ways to reduce side-effects of HRT

A
  1. Reduce dose
  2. Take with food
  3. Change type of hormone
  4. Change route of administration
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15
Q

State 5 HRT alternatives

A
  1. Selective oestrogen receptor modulator
  2. Selective serotonin reuptake inhibitors (SSRI) low dose
  3. Serotonin-norepinephrine reuptake inhibitors (SNRIs) low dose
  4. Antihypertensives (alpha agonists)
  5. Antiepileptic
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16
Q

Describe the mechanism of action of Selective oestrogen receptor modulators

A
  1. Selectively binds to receptors depending on tissue type

2. Is simultaneously oestrogen and anti-oestrogenic in different tissues

17
Q

How long should contraception be used since last period?

A

2 years if under 50

1 year if over 50