Menopause and Premature Ovarian Insufficiency Flashcards
menstrual cycle involves which two cycles
OVARIAN CYCLE
• Follicular phase
• Ovulation
• Luteal phase
UTERINE CYCLE
• Menstruation
• Proliferative phase
• Secretory phase
How does age effect males and female fertility
males do not run off in gametes or become less fertile, they do expierience senescent changes like women.
women gametes do run out and fertility drops, they get senescent changes and menopause
define menopause
Defined as the Last Menstrual Period (LMP)
FSH high >30
• Oestradiol low <203
what happens in menopause
oocytes decrease no estyrogen produced because no ovulation therfore FSH rises, causes menstrual irregularities, psychological changes and physical
menopause does what to fsh and oestrogen
hyper fsh, hypo oestrogenism
what are the symptoms of menopause
symptoms • The Hot Flush/The night sweat (75% women in first 2 years) • Headaches • Palpitations • Leg Cramps • Uro-genital symptoms (10- 40% women) • Reduced libido • Mood changes • Greene Climateric Scale
Menopause – Long Term Consequences
Osteoporosis
• In adults, oestrogens are crucial for the maintenance of bone
Cardiovascular Disease • Coronary artery disease • Stroke • Venous thromboembolism • Pulmonary embolism Vaginal Dryness and atrophy Alzheimers
Menopause – Treatment Options
HORMONAL • Oestrogen - Reverse symptoms and effects of low oestrogen • Progesterone - Necessary to protect the endometrium if uterus present - Not required in women without a uterus • Testosterone - Increases overall energy level - Enhances sexual desire and arousal
NON-HORMONAL • Lifestyle measures • Replens • Alpha 2 agonists -clonidine • SSRI’S • Gabapentin
benifits of HRT for menopause
• Alleviate symptoms • Protect bones • Reduces incidence of Colorectal cancer • ? Protect CVD • Improve quality of life
risk of hrt for menopause
RISKS • VTE • Breast Cancer • Endometrial cancer • ? CVD
What is premature ovarian insufficiency
‘Premature menopause’ or ‘Premature ovarian failure’
• Diagnosis
– Amenorrhoea 4 months
– FSH>30U/L on two occasions 6 weeks apart
– Women less than 40 years of age.
Not enough eggs
outline genetic contribution to POI
30% of IPOI is familial (FPOI) – likely underestimation
• FMRI premutation
– X-linked dominant inheritance
– 55 to 200 trinucleotide repeat CGG s in Non-Coding DNA
– Full mutation (>200 repeats) leads to fragile X mental retardation
• RR of 9 if a sibling has POI
• RR of 12.4 if multiple family members
how does POI parthenogenesis differ to menopause
Mechanisms different to natural menopause
natural menopause is an evolutionary conserved trait
