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
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
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