Menopause and HRT 5 Flashcards

Apply knowledge of menopause to clinical scenarios and begin to understand counseling and informed consent.

1
Q

What are the major steps in diagnosing perimenopaus?

A
  • Clinical diagnosis, look for cardinal symtpoms
  • FSH levels are too variable in this age group to be useful
  • In postmenopausal years:
    • FSH > 40 mlU/ml
    • E2 < 25 pg/ml
  • Use lab tests to rule out other diagnoses:
    • hypothyroidism
    • hypothalamic amenorrhea
    • hyperprolactinemia
    • PCOS
    • non-GYN diseases
    • POF
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2
Q

What is the prognosis of perimenopausal symptoms?

A
  • Cardinal symptoms resolve over tie if untreated
    • 12% will have long-term/lifetime symptoms
  • Vulvovaginal atrophy will not get better without treatment
    • will often get worse if not treated
  • Increased risk for clinical depression returns to baseline risk in postmenopausal years
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3
Q

What are some factors to properly handling patients who present with perimenopause?

A
  • Informed consent
  • Discuss all:
    • pros/cons
    • risks/benefits
    • indications
    • treatment alternatives
  • Document this in medical record
  • For high risk patients, consider signed, written consent
  • Make sure patient has had exam and updated lbas like:
    • chemistries
    • lipid panel
    • thyroids screen
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