Menopause: What's the big deal Flashcards
Menopause?
One year without menses
Perimenopause?
Age group near menopausal age, 45-55. With symptoms - menopausal transition
Postmenopause?
Beyond menopause or age > 55
Does the ovary continue to produce eggs after age 43?
Yes –> sporadically, they are abnormal
How much estrogen is being produced in perimenopausal women?
Low amounts
What rises because of the low amount of estrogen produced?
FSH
Menses become what in perimenopause?
Less frequent, lighter
Most common symptom of menopause?
Hot flashes
What causes hot flashes?
Gonadotropin spike as well as estrogen deficiency
When can hot flashes begin?
During perimenopause
What else can hot flashes cause?
Vasodilation and skin changes
During menopause what can occur at night?
Wake up with sweats followed by a cooling effect
Night sweats during menopause can occur how many times per night?
Up to 5
What will happen to the night sweats with no treatment?
Will dissipate
When do you give estrogen for hormone replacement therapy?
If there are moderate-to-severe vasomotor symptoms associated with menopause
Why do add a progesterone replacement drug in some women?
If they still have a uterus to prevent endometrial cancer
What is the preferred treatment for pts with only vaginal symptoms (dryness or dyspareunia)?
Vaginal Estrogens
- No progestins needed
Do women who had a hysterectomy need to take progesterone replacement?
Nope
Other symptoms of menopause?
Vaginal atrophy –> late effect
How do you treat vaginal atrophy?
Estrogens - either vaginally or systemically
Medical illnesses associated with menopause?
Osteoporosis
Cancer
Heart disease
High risk grps for osteoporosis?
White/Asian Thin Smoker Alcohol use Steroid use FHx
The number one killer of older women?
CVD
What is early loss of endogenous estrogen associated with?
CVD
What does endogenous estrogen do for the CV system?
Increases smooth muscle proliferation, lowers cholesterol, increases vascular tone
What does a women’s CV system look like at age 35?
Fatty streaks and minimal athersclerotic plaque
What happens at age 45?
Lesions begin to progress (Perimenopause)
What happens 5-8 years after menopause?
Increase in plaques and intima-media thickening
When does women’s CV risk equal men’s?
after 65
Do you give estrogen to treat secondary CVD in females?
No –> increases risk for heart attack
What is the use of HT in perimenopause?
Positive effects on vascular remodeling of age
Decreases intimal thickening
Decreases the incidence of plaques
How long must you be on EPT before an increase in risk of breast cancer occurs?
5 years
