S10.2 Menopause

Question 1

Define menopause

Answer 1

Cessation of menstrual cycles for 12 months due to loss of ovarian follicular activity.
Occurs around 45-55 years

Question 2

Describe the hormonal changes which lead to menopause

Answer 2

Oestrogen dramatically falls, FSH and LH increase, FSH dramatically increases as no inhibin.

Question 3

Describe some of the key symptoms of menopause

Answer 3

Ovaries become smaller so less oestrogen produced
Vascular changes - hot flushes
Skin loses elasticity 
Weight increase 
Hair becomes dry  
Voice becomes deeper
Breast becomes flat

Question 4

Describe the phases of menopause

Answer 4

Pre-menopause: from 40y, follicular phase shortens and ovulation is early/absent: decreased oestrogen and progesterone, LH and FSH rise

Peri-menopause: physiological changes associated with the end of reproduction capacity

Post-menopausal: 12 months amenorrhea

Question 5

What are some consequences of oestrogen deficiency?

Answer 5

Early (40-50): hot flushes, sweating
Intermediate (55-65): vaginal atrophy, dyspareunia
Late (65+): osteoporosis, atherosclerosis

Question 6

Outline the uses of hormone replacement therapy

Answer 6

Low levels of hormones given: oestrogen and progestogen.

Relieves menopause symptoms, improves quality of life, reduces depressive symptoms, improves vaginal dryness and atrophy, reduces osteoporosis risk

Question 7

Why are oestrogen only preparations not given to women who have not had a hysterectomy?

Answer 7

As they require progesterone to protect the endometrium from any risk of cancer