Menopause- Seibert Flashcards
The definition of _______ is the final menstrual period confirmed after 1 year of no menstrual bleeding
menopause
What does perimenopause mean?
the time around menopause “the menopause transition”
What is induced menopause?
Cessation of menstruation that follows bilateral oophrectomy with or without hysterectomy or chemotherapy, pelvic radiation or surgical menopause (iatrogenic)
Any menopause that happens before the age of ____ is permature menopause
40
What is the typical age women hit menopause?
51
What is post menopause?
The years after the Final Menstrual Period resulting from natural or premature menopause (about 1/3 of a woman’s life)
What two parameters are helpful in establishing diagnosis of menopause?
- Esrtadiol <20
- FSH 21-100
An FHS > than _____ mlU/ml is highly suggestive of menopause
30
What menstrual bleeding changes can a women undergoing menopause expect?
Lighter bleeding, heavier bleeding, duration of bleeding, skipped menstrual periods and amenorrhea
If a patient has menstrual bleeding lasting >7 days or >2 days longer than usual, spotting in between periods and bleeding after intercourse what could this be a sign of and what should you do?
Abnormal uterine bleeding and you want to refer for bx
A female patient age 51 comes in with hot flashes, sensation of warmth all over her body and perspirations. What is the 1st line med you could put this patient on?
Paroxine (SSRI)
What can influence your vasomotor sxs with menopause?
-BMI, low income, smokers
Vasomotos sxs typically decrease however _______ symptoms tend to progress and unlikely to resolve on its own
vaginal
What is the treatment for vaginal symptoms of menopause?
Vaginal lubricants and moisturizers, and local vaginal estrogen
What is a main urinary symptom of those with menopause and how do we treat it?
Incontinence, treat with Kegel exercises
Sex health ______ with menopause so an active _____ life can help
declines, active sex life
Vaginal atrophy also increases the risk for contracting ____
STIs
A major downside of menopause along with all the other ones is that it can cause sleep disturbance and cognitive _____
decline
T/F: Estrogen replacement does not reverse cognitive changes
TRUE -> it may actually increase the risk of decline
T/F: Those who had severe PMS will have an increased risk of mood sxs with perimenopausal years
True sadly
What is the most predictive factor for depression at midlife and beyond?
A prior hx of clinical depression
What is something we should screen for early in all women?
Osteoporosis
What should we put all women at risk for osteoporosis on?
Calcium and vitamin D
Or Alendrnoate (bisphosphonate) if higher risk or fractures
Does heart disease increase after menopause?
Yes because estrogen protects the heart
Estrogen should be given in the _______ effective dose for the _______ amount of time
lowest, shortest
In patients who don’t have a uterus? What is the tx for menopause?
Just estrogen only
In patients who do have a uterus, what is the best tx?
Combo therapy (estrogen and progesterone)
Estrogen _______ the risk of recurrence of breast CA
increases
If a patient has any of the following, what should you NOT do?
- Undiagnosed vaginal bleeding
- Active hx DVT or PR or a hx of these conditions
- Arterial thromboembolic disease (MI or stroke)
- Liver disease
- Hx endometrial CA or breast CA
- Family hx of a female cancer
Do NOT prescribe hormone replacement therapy
What is a non-hormonal drug that is first line for vasomotor menopause sxs?
Paroxitine (has sexual side effects i think dec libido and inability to have orgasm)
What is a non-hormonal anticonvulsant 1st line for menopause?
Gabapentin
What is a non-hormonal neuropathic pain drug 1st line for menopause?
pre-gablin *can cause lower extremity edema
A patient wants to try some random traditional chinese medicine and herbs like st johns wort for menopause. What should you tell her?
Go for it!
Aside from meds, what are some other things that could help symptoms?
Yoga, exercise, avoid triggers (same as migraine triggers), use lubricants
