S5 L2 Menopause Flashcards
Menopause
- What is this? Definition
- Define/explain: Menopausal transition, Early menopause, Premature menopause, surgical menopause
- Which hormones are produced in lower amounts? by what?
- After menopause, can’t get…
The end of menstruation
• From the Greek “mens” meaning “monthly’’ and “pausis” meaning “cessation”.
• Menopause is a part of a women’s natural ageing process
• It is when her ovaries produce lower level of the oestrogen and progesterone
• She is therefore no longer able to become pregnant.
• No more oocytes
Incidence of menopause
- Two groups
Menopausal phase
- Age
- 4 categories
Menopausal phase: It is the end of reproductive life
• The age of menopause ranges between 45 –55 years,
• Average being ~50 years
• The menopausal phase is usually broken down into four categories:-
1. Pre-menopause ( may be slight changes to FSH/LH levels but cycle will be relatively normal)
2. Peri-menopausal (transition menopause things start to happen to the cycle)
3. Menopause
4. Post menopause
Pre-menopause and Peri-menopause
Menopause and Post-menopause
Stages of Menopause (4)
- Duration (roughly)
- Menstrual cycle
- FSH level
- Symptoms
Reproduction age
- Reproduction life - number of oocytes that grow into mature follicles and ovulat
- Production of oestrogen by the ovaries _____ as the number of primordial follicles approaches _____
decreases
zero
_____ and _____ of oocytes changes as function of age?
- Overtime, what happens to the number and quality…
- What happens to hormone levels after menopause?
Quantity and quality
- FSH stays high (trying to stimulate the follicles! - Even though no follicles to stimulate!)
- Oestrogen - Low
- Progesterone and inhibin - Reduced/loss
Summary - cause of menopause
- occurs when…
- hormone levels…
- HPG axis showing the normal hormone axis
Recap:
- hormone levels during menopause
- Oestrogen is falling
- FSH is increasing
- Reduction/loss of inhibin and progesterone
Use FSH to diagnose physiological menopause
Physiological symptoms of menopause
Explain the hot flush
Hot flush:
• Vascular changes
• Effects ~80% to some degree
• Transient rises in skin temperature & flushing
• Relieved by oestrogen treatment
Consequences of oestrogen deficiency
As getting closer to menopause, may see…
Dysfunctional uterine bleeding:
- Observations
- Caused by changes in oestrogen
Psychological changes and the menopause
Changes to the ovary at menopause
Psychologocial changes…
The psychological changes are mainly manifested by
• frequent headache,
• irritability,
• fatigue,
• depression and insomnia .
• Although these are often said to be due to changes in the hormonal levels, they are more likely to be related to the loss of sleep due to night sweat.
• Diminished interest in sex may be due to emotional upset or may be secondary to painful intercourse due to a dry vagina
Menopause will cause changes in general appearance…
Menopause will effect GI and urinary systems
Skin: Collegen is stimulated/helped by ostrogen
• The skin loses its elasticity and becomes thin and fine. This is due to the
loss of elastin and collagen from the skin.
• Weight: Fat drives androgen production (leading to oestrogen increase), oestrogen is unapposed… cancer risk
Weight increase is more likely to be the result of irregular food habit due to mood swing . There is more deposition of fat around hips, waist and buttocks.
• Hair: Hair become dry and coarse after menopause . There may be hair loss
due to the decreasing level of oestrogen.
• Voice: Voice become deeper due to thickening of vocal cords.
Changes occuring in the genital organs
External genital organ changes
Changes occuring in the genital organs:
• The uterus can become small and fibrotic due to atrophy of the muscles after
the menopauses
• Regression of endometrium - No longer under the control of oestrogen, making it increase and decrease…
• Shrinkage of myometrium
• The cervix become smaller and appears to become flush (closer) with vagina. In
older women the cervix may be very difficult to identify separately from vagina
• Thinning of cervix
• Vaginal rugae lost
How does menopause affect bones?
How does menopause affect the cardiovascular system?
Summary of the pathophysiology of the menopause
Therapeutic interventions to alleviate the symptoms of menopause - HRT
Hormone Replacement Therpay with oestrogen and progesterone
Advantage and disadvantage of each type of treatment for menopause
