Menopause and HRT 2 Flashcards
List the cardinal signs/symptoms of the perimenopause.
1
Q
List the cardinal signs/symptoms of perimenopause.
A
- Menstrual change
- Vasomotor symptoms (hot flashes or night sweats)
- Sleep disturbances
-
Vulvovaginal atrophy
- dyspareunia
- dryness
- burning
-
Mood disturbance
- depressed mood
- anxiety
- irritability
- clinical depression
2
Q
What is the physiology of menopause transition?
A
-
Continual depletion of eggs in female life cycle
- 1,000 by menopause transition
- 0 after menopause
-
Follicular depletion
- decreased inhibin B
- increased and erratic FSH
- leads to erratic ovulation
- menstrual cycle irregularity
- INCREASED estradiol, heavier menses
- eventual fall in estradiol due to inadequate production
- Bleeding is abnormal in postmenopausal years
3
Q
What is the pathophysiology behind hot flashes?
A
- Most common symptom in perimenopause, not well understood
- Characterized by sudden onset of heat that beings at the head and neck and spreads throughout the body, lasting from 1-5 minutes
- sweating and flushing
- anxiety and palpitations
- shivering may follow
- disrupts sleep
-
Associated with:
- genetic predisposition
- noradrenergic and serotonergic systems
- change in thermoneutral zone of the hypothalamus
- narrower
- small changes promps heat response
- Treat with estroegen, widen threshold
- clonidine also helps with lowering brain NE and increasing sweating threshold