O+G- Menopause + Fibroids Flashcards
During the perimenopause, the levels of LH do what?
a) Rise
b) Fall
c) Stay the same
a) Rise
LH rises during the perimenopause
What age is the average menopausal age for women?
a) 48
b) 52
c) 49
d) 51
d) 51
The average age is 51 however for most women it’s between the ages of 49 and 52
What treatment would you give to a women suffering menopausal symptoms who had previously had a hysterectomy?
a) Oestrogen only HRT
b) Combined oestrogen & progestogen HRT
c) SSRI
d) Gabapentin
a) Oestrogen only HRT
Oestrogen only, progesterone is not needed as the womb has been removed
What is ‘menopause’?
The menopause is a naturally occurring period in a woman’s life when their menstrual periods and ovulatory function stops
Onset of the menopause starts with the cessation of menses for at least 12 consecutive months
What age does menopause usually occurs?
Typically occurs between the age of 49 & 52
WHat are the different classification for menopause?
Premature menopause:
Premature ovarian insufficiency:
Perimenopause:
What is Premature menopause:
Menopause before the age of 40 years is considered premature and may occur spontaneously or because of surgery, radiation of the pelvis, chemotherapy, autoimmune disease, fragile X syndrome, or idiopathically
What is Premature ovarian insufficiency:
Refers to amenorrhoea, hypo-oestrogenic status, and elevated gonadotrophins due to a decline of ovarian function before the age of 40.
What is Perimenopause:
The transition from cyclic menstrual bleeding to a total cessation of menses may happen over several years; duration is variable. Perimenopause is marked by menstrual irregularity and periods of amenorrhoea due to declining progesterone and estradiol levels, and ends 12 months after the final menstrual period.
During menopause which hormones start to decline?
progesterone, estradiol and testosterone
Before the menopause what hormones start to rise due to altered folliculogenesis and reduced inhibin secretion.
FSH and LH
Symptoms of menopause?
- Amenorrhoea • Irregular menstrual cycle
- Hot flushes & night sweates
- Vaginal dryness, itching, discharge and painful intercourse
- Decreased libido
- Mood changes
- Increased risk of fractures
- Increased risk of cardiovascular disease
RF for menopause?
- Age 40-60 years
- Cancer treatment
- Smoker
- Ovarian surgery
A 50-year-old schoolteacher presents complaining of night sweats and difficulty sleeping. She has also noticed a decrease in her libido and discomfort during intercourse. Her family complains that she is more irritable. She has not had a period for 12 months; immediately prior to that her periods were lighter and shorter. On pelvic examination, the labia minora appear thin and the vaginal mucosa is slightly pale, but the rest of the physical examination is unremarkable
This is a menopause history
what are the key points in this passage that indicate menopause?
A 50-year-old schoolteacher presents complaining of night sweats and difficulty sleeping. She has also noticed a decrease in her libido and discomfort during intercourse. Her family complains that she is more irritable. She has not had a period for 12 months; immediately prior to that her periods were lighter and shorter. On pelvic examination, the labia minora appear thin and the vaginal mucosa is slightly pale, but the rest of the physical examination is unremarkable
Ix menopause?
- Pregnancy test
- FSH test – recommended only in women under 40-45 yrs as women over that age have variability in levels of FSH. Elevated >30 IU/L
- Serum estradiol - Positive <110 picomol/L
