Menopause & Secondary Amenorrhoea Flashcards

1
Q

what is the average age of menopause in the UK?

A

51

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what age is classed as premature menopause?

A

40 years or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens to hormones in ovarian insufficiency?

A

oestradiol falls

FSH rises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

menopause may be natural or follow?

A

oophrectomy/chemo/radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

symptoms of menopause (5)?

A
vasomotor - hot flushes
vaginal dryness/dyspareunia
low libido 
muscle and joint aches 
mood/poor memory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

silent change in menopause?

A

osteoporosis

reduced bone mineral density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what score for osteoporosis?

A

FRAX score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

prevention and treatment of osteoporotic changes?

A

excercise
calcium + vitD
bisphosphonates

denosumab - monoclonal AB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HRT modes? best?

A
systemic: gel/oral, 
transdermal patch (less risk VTE)

local: vaginal oetrogen only via pessary/ring/cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when do you use oestrogen only or oestrogen + progestogen?

A

oestrogen only if no uterus

oestrogen + progestogen if uterus present to prevent endometrial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

contraindication to systemic HRT? (3)

A

current hormone dependent cancer of breast/endometrium

current active liver disease

un-investigated abnormal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

combined E + P cycle?

A

taken daily

14 days E + 14 days E+P

withdrawal bleeding after stop P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

menopause symptom treatment? (3)

A

Selective Estrogen Receptor Modulators (SERMs)

SSRI antidepressants

Naturel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HRT risks? (5)

A
breast cancer with combined
ovarian cancer
VTE if oral route of admin
Fractures
Ca colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

NICE guidance on HRT?

A

severe vasomotor symptoms

women with premature ovarian insufficiency (benefits till 50)

not as first line for osteoporosis

vaginal estrogen for vaginal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is andropause?

A

testosterone falls by 1% a year after age 30

fertility remains, no sudden change

17
Q

What is primary amenorrhoea?

A

never had a period

more than 14yrs and no secondary sexual characteristics

more than 16 if they have secondary sexual characteristics

18
Q

What is secondary amenorrhoea?

A

has had periods in the past but none for 6 months?

19
Q

Secondary amenorrhoea causes?

A
pregnancy
contraceptions (depoprovera)
POCS
early menopause
Thyroid diseases
raised prolactin
hypothalamic stress
androgen secreting tumour
20
Q

Secondary amenorrhoea exam and tests?

A
BMI + Cushingoid
Androgenic signs
Abdo exam
Urine pregnancy test
pelvic US
bloods
21
Q

what bloods in secondary amenorrhoea? (5)

A
FSH
Oestradiol
Prolactin
Thyroid
Testosterone
22
Q

what is PCOS?

A

a set of symptoms due to elevated androgens (male hormones) in females

23
Q

diagnosis of PCOS?

A

PCO morphology on scan

clinical/biochemical hyperandrogegism

oligo/anovulation - amenorrhoea or infertility

(2 out of 3 of the above)

24
Q

main underlying problem in PCOS?

A

increased insulin resistance

25
Q

PCOS management?

A

weight loss
antiandrogen - CHC
endometrial protection
fertility - clomiphene