Menopause and Fertility Flashcards
How is the menopause defined?
Lack of menstruation for over 1 year
FSH and LH high
Oestrogen Low
Ovarian failure
What are some signs and symptoms of the menopause?
Hot flushes Vaginal dryness and atrophy reduced libido Osteoporosis Dyspareunia Overactive bladder (frequency/urgency)
How is menopause treated?
Only if premature or woman is suffering
HRT –> oestrogen and progesterone if woman has uterus
just oestrogen if no uterus
What is associated with HRT?
Increased risk of VTE
Increased risk of breast and endometrial cancer
Increased risk of vascular disease
What is primary infertility?
Unprotected sex regularly for 1 year and no pregnancies
What is secondary infertility?
Unprotected sex regularly for over a year with a previous pregnancy
What are some female causes of infertility?
PCOS
Ovarian failure (menopause, Turners,)
Hypothalamic-pituitary failure (hyperprolactinaemia, stress/weight loss)
PID causing tubal dysfunction
What are some male causes of infertility?
Failure of sperm production (klinefelters)
Previous orchiditis
Failure of transport (CF, sterilization)
How is female infertility investigated?
FSH and LH levels
Day 21 progesterone level (confirms ovulation)
Pelvic USS
Karyotype
How is male infertility investigated?
FSH, LH
Semen analysis
Karyotype
How is infertility treated?
Clomifene to induce ovulation GnRH Tubal surgery Sperm donation Oocyte donation IVF Intracytoplasmic sperm injection
