MW Lecture 12

Question 1

How many years prior to menopause is perimenopause?

Answer 1

2-8 years

Question 2

Perimenopause symptoms

Answer 2

Irregular menstrual cycles and decrease in cycle length

Question 3

Menopause definition

Answer 3

Permanent cessation of menses (period) following loss of ovarian follicular function

Question 4

Menopause diagnosis

Answer 4

Amennorhoea for 12 consecutive months

Question 5

Common symptoms of menopause

Answer 5

Hot flushes
Night sweats
Vulvovaginal atrophy of tissues
Vaginal dryness
Dyspareunia (painful intercourse)

Question 6

Less common symptoms of menopause

Answer 6

Mood swings
Depression
Insomnia
Arthralgia (joint pain)
Myalgia (muscle pain)
Urinary frequency
Decreased libido

Question 7

Physiology of vasomotor symptoms in menopause

Answer 7

Reduced hormones increases the hypothalamus’ sensitivity to changes in body temp

Question 8

Goal of HRT in menopause

Answer 8

Alleviate or reduce menopausal symptoms

Vasomotor symptoms

Question 9

Guidance for dosing HRT in menopause

Answer 9

Lowest dose for the shortest duration

Question 10

When to add progesterone to HRT

Answer 10

If the women has a uterus to prevent endometrial hyperplasia and increased cancer risk

Question 11

Outcome of Danish Study for HRT

Answer 11

Lowest effective dose should be used for the shortest possible time and the need to continue HRT should be reviewed at least yearly

Question 12

Premature menopause age

Answer 12

Under 45 years

Question 13

Adverse effects of HRT

Answer 13

Irregular bleeding

Nausea and breast tenderness

Question 14

Discontinuing HRT

Answer 14

Often stopped within 2 years
Determines if symptoms have resolved
Divided over stopping abruptly or withdraw slowly

Question 15

Use for topical vaginal oestrogen

Answer 15

Vaginal dryness, soreness and pain during intercourse

Increased urinary frequency and urgency