Menopause & Secondary Amenorrhoea Flashcards
what is the average age of menopause in the UK?
51
what age is classed as premature menopause?
40 years or less
what happens to hormones in ovarian insufficiency?
oestradiol falls
FSH rises
menopause may be natural or follow?
oophrectomy/chemo/radiotherapy
symptoms of menopause (5)?
vasomotor - hot flushes vaginal dryness/dyspareunia low libido muscle and joint aches mood/poor memory
silent change in menopause?
osteoporosis
reduced bone mineral density
what score for osteoporosis?
FRAX score
prevention and treatment of osteoporotic changes?
excercise
calcium + vitD
bisphosphonates
denosumab - monoclonal AB
HRT modes? best?
systemic: gel/oral, transdermal patch (less risk VTE)
local: vaginal oetrogen only via pessary/ring/cream
when do you use oestrogen only or oestrogen + progestogen?
oestrogen only if no uterus
oestrogen + progestogen if uterus present to prevent endometrial hyperplasia
contraindication to systemic HRT? (3)
current hormone dependent cancer of breast/endometrium
current active liver disease
un-investigated abnormal bleeding
combined E + P cycle?
taken daily
14 days E + 14 days E+P
withdrawal bleeding after stop P
menopause symptom treatment? (3)
Selective Estrogen Receptor Modulators (SERMs)
SSRI antidepressants
Naturel
HRT risks? (5)
breast cancer with combined ovarian cancer VTE if oral route of admin Fractures Ca colon
NICE guidance on HRT?
severe vasomotor symptoms
women with premature ovarian insufficiency (benefits till 50)
not as first line for osteoporosis
vaginal estrogen for vaginal symptoms