Menopause trigger

Question 1

how much does smoking advance menpause

Answer 1

2 years

Question 2

what happens to androstenedione in menopause

Answer 2

it decreases
this is the primary androgen in women

Question 3

in what condition does the vaginal pH increase

Answer 3

atrophic vaginitis (become basic)

Question 4

replens, vagisil, and K-Y liquibeads are all types of what

Answer 4

vaginal moisturizers

use daily! then use lubricators during sex.

for atrophic vaginitis

Question 5

what type of atrophic vaginitis uses vaginal estrogen therapy

Answer 5

moderate-severe

Question 6

restored vaginal flora, secretions, pH and thickness. also leads to lower risk of overactive bladder and UTIs

what treatment is this

Answer 6

vaginal estrogen therapy

Question 7

taking an aromatase inhibitor (anazstrazole) is contraindicated with what treatment

Answer 7

vaginal estrogen therapies

Question 8

this treatment mimics estrogen only in the vaginal tissues

Answer 8

ospemifene

Question 9

MC SE of this treatment is hot flashes

Answer 9

ospemifene

Question 10

when is prasterone suppository used?

Answer 10

an alternative treatment for atrophic vaginitis if unresponsive to conservative therapy and unable/unwilling to take topical estrogens

ospemifene is also used for this

Question 11

when is ospemifene used

Answer 11

alternative treatment for atrophic vaginitis if unresponsive to conservative therapy and unable/unwilling to take topical estrogens

prasterone is also used for this

Question 12

what vital sign changes occur during hot flashes

Answer 12

elevations in HR seen but NO heart rhythm changes or BP changes.

Question 13

what SE of menopause can lead to insomnia and cognitive/psych symptoms

Answer 13

hot flashes (night sweats!)

Question 14

when is progestin (depot medroxyprogesterone acetate IM or norethindrone PO ) used in this lecture

Answer 14

hot flashes for women who cannot take estrogen

also used as additive to MHT for patients who have not undergone a hysterectomy.

Question 15

when is tibolone used

Answer 15

alternative to estrogen therapy for hot flashes.

Question 16

SNRIs, SSRIs, black cohosh/phytoestrogens, gabapentin, and clonidine are all used for what diagnosis

Answer 16

Non hormonal treatments for hot flashes

Question 17

what medication canNOT be taken with tamoxifen (breast cx tx)

Answer 17

paxil/paroxetine (SSRI)

Question 18

when are oxybutynin and neurokinin-3 receptor antagonists used.

Answer 18

emerging therapies for hot flashes

Question 19

the two biggest known benefits of this treatment is reduced menopausal symptoms and reduced risk of osteoporosis

Answer 19

MHT/HRT

Question 20

if your patient is only having GU s/s in menopause, what is the likely preferred route of medication

Answer 20

intravaginal

can also use oral or transdermal, all three are the same efficacy!

Question 21

if your patient is experiencing mostly vasomotor s/s of menopause, what is the treatment route

Answer 21

transdermal (1st line)

Question 22

risks for this treatment includes gallbladder dz, clots, stroke, breast cx, and endometrial cx.

Answer 22

MHT

Question 23

why do you add progesterone to MHT tx

Answer 23

to lower risk of developing endometrial cx

Question 24

this lowers LDL but increases HDL and TG

Answer 24

MHT

Question 25

if a patient who hasn’t had a hysterectomy wishes to undergo estrogen therapy for postmenopausal s/s, what must be added to her tx regimen

Answer 25

progestin in the form of medoxyprogesterone acetate (MPA) or micronized progesterone.

Question 26

what is contained in soy, lentils and chickpeas?

Answer 26

phytoestrogens/isoflavones