Pathophysiology Of Menopause Flashcards
What is the average age of menopause?
51
What is the main menopausal estrogen?
Estrone
How is estrone produced?
In the peripheral adipose tissue and postmenopausal ovary by the aromatisation of adrenal androstenedione
What are the acute symptoms of menopause?
- Hot flushes
- Night sweats
- Insomnia/Fatigue
- Memory loss
- Mood changes
What are the long term symptoms of menopause?
- Depression
- Loss of libido
- Urethral syndrome
- Vaginal atrophy
How does menopause affect thermoregulation?
The neurotransmitters that deal with thermoregulatory thresholds are affected by the change in hormones - this causes the thermoneutral zone to narrow so it’s easier for one to get hot.
What is the link between menopause and depression?
Estrogen increases the levels of serotonin and noradrenaline. When estrogen decreases, so do these neurotransmitters. Depression is associated by lower levels of serotonin and noradrenaline.
What is the link between menopause and memory loss?
It’s unclear - some trials suggest that estrogen is linked to cognitive function, such as memory. Estrogen replacements can lessen the presence of memory loss.
How is the vaginal histology affected by menopause?
There is estrogen-deficiency atrophy:
- Marked thinning of the epithelium
- Reduced blood supply
- Loss of glycogen
What happens to the vagina in menopause?
There is dryness in the vagina, which can lead to painful sex. Topical estrogen creams and lubricant can help with this.
What is the link between menopause and osteoporosis?
Estrogen plays an important role in bone density - when estrogen levels drop, the bones are less dense and one is at greater risk of osteoporosis.
How is menopause diagnosed?
If there has been no menstrual bleeding in over a year. Hormone tests can be administered to: menopause = higher FSH and lower estrogen. AMH levels can be measured, if they’re below 5 then its menopause.
What is AMH?
Anti-mullerian hormone - it counteracts the recruitment of primordial follicles, stopping there being too many follicles released in a cycle.
How do AMH levels help determine menopause?
AMH gives an indication of how many functional follicles are left in the ovaries, which can tell us how long it is until a woman can no longer reproduce.
Explain hot flashes
A vasomotor response to the decreased levels of estrogen - the neurotransmitters involved in thermoregulation are affected, causing a decrease in the thermoregulatory threshold.
