Menopause and Secondary Amenorrhoea Flashcards
What is the definition of menopause?
Last lifetime period
What is the average age for menopause?
51
What is the cause of menopause?
Ovarian failure - estradiol falls, FSH rises
What are the symptoms of menopause?
Vasomotor symptoms (hot flush) Vaginal dryness/soreness Low libido Muscle and joint aches Mood changes Poor memory
What is the ‘silent risk’ of menopause?
Reduced bone mass, could lead to osteoporosis
What are the risks associated with osteoporosis?
Thin Caucasian Smoking Amenorrhoea Steroid use Malabsorption Hyperthyroidism EtOH
What is the prevention and treatments for osteoporosis?
Weight bearing exercises
Adequate calcium and vitamin D
HRT
Bisphosphonates
What are the symptom treatments for menopause?
Hormone replacement therapy
Selective oestrogen receptor modulators
Antidepressants
Non hormonal lubricants
What are the different types of HRT?
Local vaginal pessary/ring/cream
Systemic transdermal/oral
What are the benefits of HRT?
Vasomotor
Local genital symptoms
Osteoporosis
Colon cancer
What are the risks of HRT?
Breast cancer
Ovarian cancer
Venous thrombosis
What is andropause?
Testosterone falls by 1% a year after 30
What is primary amenorrhoea?
Never had a period
What is secondary amenorrhoea?
Has had periods in past but none for 6 months
What are the causes of secondary amenorrhoea?
Pregnancy /breastfeeding Contraception Polycystic ovaries Early menopause Thyroid disease/Cushings Raised prolactin Hypothalamic (stress, weight change, exercise) Androgen secreting tumour Sheehans syndrome Ashermans syndrome
What investigations would you use for secondary amenorrhoea?
Urine pregnancy test and dipstick for glucose
Bloods (FSH, LH)
Pelvic USS
What would you look for in an examination for secondary amenorrhoea?
BP BMI Acne Hirsutism Enlarged clitoris/ deep voice
How to polycystic ovaries present?
Oligo/amenorrhoea
Androgenic symptoms (hair, acne)
Anovulatory infertility
First trimester miscarriage
What are polycystic ovaries associated with?
Diabetes
Cardiovascular disease
How are polycystic ovaries managed?
Weight loss/exercise
Antiandrogen (combined hormonal contraceptive)
Endometrial protection
