Menopause and HRT Flashcards
What is the average age for the menopause?
51
What is the definition of menopause?
The time when there has been no menstrual periods for 12 consecutive months. It is a retrospective diagnosis
How long does the perimenopause usually last?
4 years
What is the typical pattern of the menopause?
The cycle length shortens, followed by skipped periods, until it eventually stops
What are the symptoms of menopause?
- Hot flushes
- Night sweats
- Vaginal dryness
- Loss of libido
- Emotional changes
- Stress incontinence
- Concentration and memory problems
- Sleep disturbance
- Osteoporosis
- Headaches and migraines
What is the definition of early menopause?
Menopause <45 years
In which cases can FSH be used as a diagnostic test and how is it used?
Only if early menopause!!
2 readings of FSH>30 1 month apart to diagnose
How can the vasomotor menopausal symptoms be managed?
CLONIDINE
ANTIDEPRESSANTS (SSRI/SNRI)
GABAPENTIN
How should menopausal symptoms be investigated?
Bedside: BP, BMI
Bloods: TSH, FSH, blood glucose, cholesterol
Imaging: Cervical screening
How can menopausal osteoporosis be treated?
BISPHOSPHONATES
STRONTIUM
CALCIUM AND VITAMIN D SUPPLEMENTATION
What are some non-pharmacological options for easing the symptoms?
- Herbal products
- Phytoestrogens/soy
- Progesterone creams
- Homeopathy and reflexology
- Exercise
What are the benefits of HRT?
Decreased osteoporosis
Decreased colorectal cancer
Decreased cardiovascular disease
What are the risks of HRT?
- Endometrial cancer (oestrogen only, as progesterone protects from it)
- Breast cancer
- Stroke
- VTE
- Ovarian cancer
In which cases can women take oestrogen only HRT?
If they have had a hysterectomy (no risk of cancer)
How should HRT be administered?
Transdermal patches