Menopause Lecture Flashcards
To define menopause, must have amenorrhea (without period) for….
1 year
Average menopause age
51
Permanent cessation of menstruation that occurs after the loss of ovarian activity
Menopause
Menopause transition (formerly “perimenopause”) can last about…
4 years
- Estradiol and progesterone decrease
- Follicle-stimulating hormone (FSH) increase
occurs during..
menopause transition
Are there any blood tests indicated to diagnose menopause?
NO
“Day 1 of menstrual cycle” is…
first day of your period
When giving a menopausal women estrogen (and she has a uterus), what else MUST you give her to avoid giving her endometrial cancer
Progesterone
During menopause, are you producing estrogen and progesterone?
NO
Menopause symptoms can begin how many years before periods stop?
1-3 years
Vasomotor (hot flashes)
Vaginal symptoms (inelastic, dry)
Sleep disturbances
New-onset depression
Menopausal symptoms
- “sudden sensation of extreme heat in the upper body, particularly the face, neck and chest”
- episodic, typically last 1-5 minutes
- characterized by perspiration, flushing, chills, clamminess, anxiety and occasionally heart palpitations
- may interfere with sleep
- affects ~75% women
Vasomotor symptoms
- vary in frequency and duration
- 87% of women who report hot flashes experience these symptoms on daily basis, with 33% experiencing more than 10 hot flashes per day
*duration: ~6 months to 2 years although wide variation in duration and still unclear
Hot flashes
- fluctuations in reproductive hormones appear to play critical role
- thermoregulatory zone narrowed
- genetic predisposition
- ethnic and racial differences (i.e., differing perceptions, physiology and/or diets high in soy products)
- obesity
can all impact hot flashes
Vaginal atrophy is a direct consequence of a ____estrogenic state
HYPO (lower estrogen)
vaginal or vulvar dryness
discharge
itching
dyspareunia
vaginal symptoms of menopause
- loss of superficial epithelial cells in GU tract thinning of tissue
- loss of vaginal rugae and elasticity narrowing and shortening of vagina
- loss of subcutaneous fat in labia majora narrowing of introitus, fusion of labia minora and shrinking of clitoral prepuce and urethra
seen in menopause
vaginal pH more alkaline alter vaginal flora and increase risk of urogenital infx
vaginal secretions may decrease
see in menopause
color of vulva in post menopausal women
more pale
when can you give estrogen alone as treatment for menopause?
no uterus (hysterectomy)
does progesterone help with menopause symptoms?
NO! but you MUST give if a pt has a uterus in order to prevent endometrial cancer
this form of estrogen has a slightly decreased risk of DVT/clotting
estrogen patch
good to try the patch first bc of this
estrogen treatment can reduce hot flashes by…..
75%
SSRI SNRI Clonidine Gabapentin Progestin-only (not common)
alternative treatments of vasomotor symptoms (instead of estrogen)
