Menopause and secondary amenorrhoea

Question 1

what is the average age of menopause?

Answer 1

51

Question 2

what is peri menopause and pre mature menopause?

Answer 2

peri-menopause is the period when the ovaries are starting the menopause, usually 5 years before

pre mature menopause is < 45

Question 3

what ar the symptoms of the menopause?

Answer 3

vasomotor - hot flushes
vaginal dryness 
dyspareunia 
muscle and joint aches
low libido 
osteoporosis 
mood changes
memory loss

Question 4

what is responsible for the symptoms experienced during the menopause?

Answer 4

decreasing levels of oestrogen

Question 5

what is are the first line and second line treatments for increased osteoporosis after menopause?

Answer 5

bisphosphonates

HRT

Question 6

what is the first line treatment for vaginal dryness?

Answer 6

vaginal oestrogen - pessaries, ring or cream

Question 7

what conditions are post menopausal women at greater risk of?

Answer 7

osteoporosis
endometrial cancer
heart disease
cerebrovascular disease

Question 8

what hormonal changes occur with menopause?

Answer 8

oestrogen/oestradiol decreases

FSH increases (tries to stimulate ovaries)

Question 9

what are the treatments/prevention of osteoporosis in post menopausal women?

Answer 9

exercise
adequate Ca and vit D intake
bisphosphonates
HRT
denosumab

Question 10

what are the risks of HRT?

Answer 10

increased risk of breast and ovarian cancer
increased risk of venous thromboembolism
increased risk of cerebrovascular incident

Question 11

what HRT would you give to a woman who is experiencing hot flushes and low libido?
she still has her uterus.

Answer 11

HRT;
systemic oestrogen + progesterone
- transdermal patch, gel or oral

Question 12

what treatment would you give a woman who is experiencing low libido, mode changes and hot flushes? she had a hysterectomy 10 years previous.

Answer 12

systemic oestrogen
- transdermal patch, gel or oral

doesn’t require progesterone as she has no uterus

Question 13

why is progesterone given with oestrogen in HRT if they still have a uterus?

Answer 13

progesterone is required to protect the endometrium from hyperplasia/cancer etc

Question 14

what natural methods can relieve symptoms of menopause?

Answer 14

red clover
soy 
black cohosh 
hypnotherapy 
CBT

Question 15

what is andropause?

Answer 15

male menopase;
testosterone falls by 1% a year after the age of 30 
DHEAS falls
fertility remains 
no sudden change

Question 16

a patient is experiencing hot flushes due to menopause. she has had a previous history of thrombotic stroke.
what treatment would you give for the hot flushes?

Answer 16

SSRI i.e. sertraline

HRT increases risk of blood clots