Menopause/ Secondary Amenorrhoea/PCOS Flashcards
1
Q
what is this?
A
last ever period
2
Q
average age ?
A
51
3
Q
when can you start being pre-menopausal?
A
5 years before
4
Q
what age is termed as premature menopause?
A
40 years or less
5
Q
physiology of menopause?
A
Ovarian insufficiency
- reduced oestradiol
- increased FSH
6
Q
what allows there to still be some oestradiol circulating in the body?
A
peripheral conversion of adrenal androgens in fat
7
Q
symptoms?
A
- vaginal dryness / soreness
- vasomotor symptoms - hot flushes
- reduced libido
- mood changes
- muscle and joint aches
- silent change–> osteoporosis
8
Q
what is osteoporosis and what does it lead to?
A
reduced bone mass –> increased risk of fractures
9
Q
how do you prevent / treat osteoporosis in a menopausal woman?
A
- bisphosphonates + HRT
- weight bearing exercise
- Vit D + Calcium supplements
10
Q
what are the treatment options for menopause?
A
- HRT
- Non-HRT
11
Q
describe the HRT route options
A
- Local
- vaginal oestrogen pessaries / cream
- Systemic
- transdermal / oral
12
Q
why is transdermal route better than oral?
A
avoids first-pass metabolism so less chance of VTE
13
Q
what is given in HRT?
A
- if uterus not present - only oestrogen
- if uterus present - oestrogen & progesterone
- pre-menopausal
- 14 days oestrogen + 14 days oestrogen + progesterone
- post-menopausal
- 28 days both O+P
- pre-menopausal
14
Q
what are the Non-HRT options?
A
- Selective Oestrogen RECEPTOR Modulators (SERM)
- SSRI / SNRI
- Natural methods:
- Phytooestrogen
- herbal ie red clover
- hypnotherapy
- exercise
15
Q
benefits of HRT?
A
- symptomatic relief
- both vaginal symptoms and vasomotor
- reduces osteoporosis risk
- reduced colon cancer risk
