Menopause and secondary amenorrhoea Flashcards
What causes menopause?
Ovarian insufficiency- oestradiol falls and FSH rises
What are the signs and symptoms of the menopause?
Hot flushes Vaginal dryness/soreness Low libido Joint and muscle aches Mood changes Poor memory
What are the symptomatic treatment options for the menopause?
HRT
Selective oestrogen receptor modulators
Non hormonal lubricants
Whatare the options of HRT?
Local vaginal oestrogen cream/pessary/ring
Systemic transdermal/oral oestrogen and progesterone
What oral HRT would be given to a woman who is 54+ or >1 year without a period?
28 day continuous oestrogen and progesterone
What oral HRT would be given to a woman who still has ovarian function?
14 days oestrogen, 14 days oestrogen nd progesterone
What are the contraindications for HRT?
Current hormone dependent breast/endometrial cancer
Curent active liver disease
Uninvestigated abnormal bleeding
What are the possible complications of HRT?
VTE if oral
Breast cancer
Ovarian cancer
What is secondary amenorrhoea?
HAs had previous periods but none for 6 months
What are the causes of secondary amenorrhoea?
Pregnancy/breastfeeding Contraception Polycyctsic ovaries Early menopause Thyroid disease Cushings Raised prolactin Stress Weight change Sudden increase in exercise Androgen secreting tumour Sheehans syndrome Ashermans syndrome
What is Sheehans syndrome?
Pituitary failure
What is Ashermans syndrome?
Intrauterine adhesions
What investigations are done for secondary amenorrhoea?
Exam- BP. BMI, hirsutism, Cushingoid, enlarged clitoris, deep voice Pregnancy test Urine lipstick for glucose Bloods Pelvic US
What bloods are done for secondary amenorrhoea?
FSH, LH Oestradiol Prolactin Thyroid function Testosterone
What is the treatment of secondary amenorrhoea?
Treat specific cause
