Menopause trigger Flashcards
how much does smoking advance menpause
2 years
what happens to androstenedione in menopause
it decreases
this is the primary androgen in women
in what condition does the vaginal pH increase
atrophic vaginitis (become basic)
replens, vagisil, and K-Y liquibeads are all types of what
vaginal moisturizers
use daily! then use lubricators during sex.
for atrophic vaginitis
what type of atrophic vaginitis uses vaginal estrogen therapy
moderate-severe
restored vaginal flora, secretions, pH and thickness. also leads to lower risk of overactive bladder and UTIs
what treatment is this
vaginal estrogen therapy
taking an aromatase inhibitor (anazstrazole) is contraindicated with what treatment
vaginal estrogen therapies
this treatment mimics estrogen only in the vaginal tissues
ospemifene
MC SE of this treatment is hot flashes
ospemifene
when is prasterone suppository used?
an alternative treatment for atrophic vaginitis if unresponsive to conservative therapy and unable/unwilling to take topical estrogens
ospemifene is also used for this
when is ospemifene used
alternative treatment for atrophic vaginitis if unresponsive to conservative therapy and unable/unwilling to take topical estrogens
prasterone is also used for this
what vital sign changes occur during hot flashes
elevations in HR seen but NO heart rhythm changes or BP changes.
what SE of menopause can lead to insomnia and cognitive/psych symptoms
hot flashes (night sweats!)
when is progestin (depot medroxyprogesterone acetate IM or norethindrone PO ) used in this lecture
hot flashes for women who cannot take estrogen
also used as additive to MHT for patients who have not undergone a hysterectomy.
when is tibolone used
alternative to estrogen therapy for hot flashes.
SNRIs, SSRIs, black cohosh/phytoestrogens, gabapentin, and clonidine are all used for what diagnosis
Non hormonal treatments for hot flashes
what medication canNOT be taken with tamoxifen (breast cx tx)
paxil/paroxetine (SSRI)
when are oxybutynin and neurokinin-3 receptor antagonists used.
emerging therapies for hot flashes
the two biggest known benefits of this treatment is reduced menopausal symptoms and reduced risk of osteoporosis
MHT/HRT
if your patient is only having GU s/s in menopause, what is the likely preferred route of medication
intravaginal
can also use oral or transdermal, all three are the same efficacy!
if your patient is experiencing mostly vasomotor s/s of menopause, what is the treatment route
transdermal (1st line)
risks for this treatment includes gallbladder dz, clots, stroke, breast cx, and endometrial cx.
MHT
why do you add progesterone to MHT tx
to lower risk of developing endometrial cx
this lowers LDL but increases HDL and TG
MHT
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
progestin in the form of medoxyprogesterone acetate (MPA) or micronized progesterone.
what is contained in soy, lentils and chickpeas?
phytoestrogens/isoflavones
