Secondarry ammenorrhoea and menopause Flashcards
What is menopause?
Last ever period
What is the average age of menopause?
51
How is premature menopause defined?
40 years or less
What is perimenopause?
5 years leading up to menopause
What causes natural menopause?
Ovarian insufficiency leading to fall in oestradiol and rise in FSH
What are non-natural causes of menopause?
May follow oophorectomy
Chemotherapy
Radiotherapy
What are symptoms of menopause?
Vasomotor symptoms - hot flushes (most common) Vaginal dryness and dyspareunia Low libido Muscle and joint aches Mood changes/?poor memory?
What happens to bone density in menopause?
It is reduced
What happens to post-menopausal women as a result of reduced bone density?
Much more at risk of fractures which leads to both increased morbidity and mortality
How can fractures be prevented in post-menopausal women?
Exercise, adequate calcium and VitD, hormonal replacement therapy, bisphosphonates
What is hormonal replacement therapy?
Administration of oestrogen if no uterus and with progesterone if a uterus is present to prevent endometrial hyperplasia
How is HRT delivered?
Transdermal patch or gel
Oral
What are positives about transdermal application of HRT?
Avoids first pass metabolism
Less risk of VTE
What are contraindications for systemic HRT?
Current hormone dependent breast/endometrial cancer
Current active liver disease
Uninvestigated abnormal bleeding
When should advice be seeked in a patient regarding HRT?
If previous VTE, thrombophilia
If previous carcinoma of the breast or BRCA carrier
