Secondary Amenorrhoea and Menopause Flashcards
What is the average age of menopause?
51
When is perimenopause?
For approximately 5 years before menopause
When is premature menopause?
40 years or less
What is menopause?
Ovarian insufficiency
=> ostradiol falls
FSH rises
Still some oestriol from peripheral conversion of adrenal androgens in fat
Menopause symptoms
Hot flushes Vaginal dryness/dyspareunia Low libido Muscle and joint aches Mood change/poor memory
Menopause symptom treatment
HRT
Menopause (silent change)
Osteoporosis
Osteoporosis prevention and treatment
Exercise Adequate calcium & Vit D HRT Bisphosphonates Teriparatide
HRT
Hormone replacement therapy
Methods of HRT
Systemic transdermal patch or gel/oral transdermal oestrogen only if no uterus
oestrogen + progestogen if uterus present to prevent
endometrial hyperplasia
Local vaginal oestrogen only pessary/ring/cream
Contraindications to systemic HRT
Current Hormone dependent cancer breast/endometrium
Current active liver disease
Uninvestigated abnormal bleeding
What is primary amenorrhoea?
Never had a period
When is primary amenorrhoea diagnosed in a girl with no 2ry sexual characteristics?
> 14 years
When is primary amenorrhoea diagnosed in a girl with 2ry sexual characteristics?
> 16 years
What is the definition of secondary amenorrhoea?
Has had periods in the past but none for 6 months
