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
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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
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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
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