Menopause- Seibert

Question 1

The definition of _______ is the final menstrual period confirmed after 1 year of no menstrual bleeding

Answer 1

menopause

Question 2

What does perimenopause mean?

Answer 2

the time around menopause “the menopause transition”

Question 3

What is induced menopause?

Answer 3

Cessation of menstruation that follows bilateral oophrectomy with or without hysterectomy or chemotherapy, pelvic radiation or surgical menopause (iatrogenic)

Question 4

Any menopause that happens before the age of ____ is permature menopause

Answer 4

40

Question 5

What is the typical age women hit menopause?

Answer 5

51

Question 6

What is post menopause?

Answer 6

The years after the Final Menstrual Period resulting from natural or premature menopause (about 1/3 of a woman’s life)

Question 7

What two parameters are helpful in establishing diagnosis of menopause?

Answer 7

• Esrtadiol <20

- FSH 21-100

Question 8

An FHS > than _____ mlU/ml is highly suggestive of menopause

Answer 8

30

Question 9

What menstrual bleeding changes can a women undergoing menopause expect?

Answer 9

Lighter bleeding, heavier bleeding, duration of bleeding, skipped menstrual periods and amenorrhea

Question 10

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?

Answer 10

Abnormal uterine bleeding and you want to refer for bx

Question 11

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?

Answer 11

Paroxine (SSRI)

Question 12

What can influence your vasomotor sxs with menopause?

Answer 12

-BMI, low income, smokers

Question 13

Vasomotos sxs typically decrease however _______ symptoms tend to progress and unlikely to resolve on its own

Answer 13

vaginal

Question 14

What is the treatment for vaginal symptoms of menopause?

Answer 14

Vaginal lubricants and moisturizers, and local vaginal estrogen

Question 15

What is a main urinary symptom of those with menopause and how do we treat it?

Answer 15

Incontinence, treat with Kegel exercises

Question 16

Sex health ______ with menopause so an active _____ life can help

Answer 16

declines, active sex life

Question 17

Vaginal atrophy also increases the risk for contracting ____

Answer 17

STIs

Question 18

A major downside of menopause along with all the other ones is that it can cause sleep disturbance and cognitive _____

Answer 18

decline

Question 19

T/F: Estrogen replacement does not reverse cognitive changes

Answer 19

TRUE -> it may actually increase the risk of decline

Question 20

T/F: Those who had severe PMS will have an increased risk of mood sxs with perimenopausal years

Answer 20

True sadly

Question 21

What is the most predictive factor for depression at midlife and beyond?

Answer 21

A prior hx of clinical depression

Question 22

What is something we should screen for early in all women?

Answer 22

Osteoporosis

Question 23

What should we put all women at risk for osteoporosis on?

Answer 23

Calcium and vitamin D

Or Alendrnoate (bisphosphonate) if higher risk or fractures

Question 24

Does heart disease increase after menopause?

Answer 24

Yes because estrogen protects the heart

Question 25

Estrogen should be given in the _______ effective dose for the _______ amount of time

Answer 25

lowest, shortest

Question 26

In patients who don’t have a uterus? What is the tx for menopause?

Answer 26

Just estrogen only

Question 27

In patients who do have a uterus, what is the best tx?

Answer 27

Combo therapy (estrogen and progesterone)

Question 28

Estrogen _______ the risk of recurrence of breast CA

Answer 28

increases

Question 29

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

Answer 29

Do NOT prescribe hormone replacement therapy

Question 30

What is a non-hormonal drug that is first line for vasomotor menopause sxs?

Answer 30

Paroxitine (has sexual side effects i think dec libido and inability to have orgasm)

Question 31

What is a non-hormonal anticonvulsant 1st line for menopause?

Answer 31

Gabapentin

Question 32

What is a non-hormonal neuropathic pain drug 1st line for menopause?

Answer 32

pre-gablin *can cause lower extremity edema

Question 33

A patient wants to try some random traditional chinese medicine and herbs like st johns wort for menopause. What should you tell her?

Answer 33

Go for it!

Question 34

Aside from meds, what are some other things that could help symptoms?

Answer 34

Yoga, exercise, avoid triggers (same as migraine triggers), use lubricants