Seibert - Menopause Flashcards
menopause is defined as final menstrual period (FMP) confirmed ___ of no menstrual bleeding
1 year
average age of menopause
51 yo
classic sx of menopause
change in menstrual cycle
night sweats
dyspareunia
sleep disturbances
memory/concentration issues
dpn/anxiety/moodiness
menstrual cycle and hormonal changes that occur a few years before and 12 mo after the final menstrual period
perimenopause
aka the menopause transition
cessation of menstruation that follows bilateral oophrectomy (w. or w.o hysterectomy) or chemo/pelvic xrt or iatrogenic
induced menopause
any menopause that occurs before 40 yo - can be natural or induced
premature menopause
lifestyle factor associated w. premature menopause
smoking
the years after the FMP resulting from natural or premature menopause; ⅓ of lifespan of most North American women
postmenopause
diagnostic tests for menopause
low estradiol: < 20
elevated FSH: 21-100
FSH > __ is highly suggestive of menopause
30
what kinds of menstrual bleeding changes are common w. menopause
all types!
light/heavy/amenorrhea
abnormal uterine bleeding (AUB) includes
heavy
>7 days or 2 or more days more than usual
< 21 days from onset of last period
spotting/bleeding btw periods
bleeding after sex
tx for vasomotor sx of menopause (ex hot flashes)
estrogens
progestins
clonidine
SSRIs/SNRIs
black cohosh
gabapentin
t/f hot flashes can also involve chills
T!
vaginal sx of menopause
dryness/itching/irritation
vaginal atrophy
dysuria/urge incontinence/easy bleeding
what vaginal sx is progressive and unlikely to resolve on its own
vaginal atrophy
urinary sx related to menopause
urge incontinence
stress incontinence
dysuria
atrophic cystitis
6 mc sx of menopause
hot flush/sweating
heart discomfort
sleep problems
dpn/anxiety
irritability
physical/mental exhaustion
sexual health sx related to menopause
decreased libido
decreased estrogen/testosterone → decreased lubrication/desire
__ increases risk for STIs in menopausal women
vaginal atrophy
main sleep disturbance related to menopause
insomnia
what should you counsel women about in regards to cognitive changes of menopause
memory/concentration problems more likely related to normal aging/mood/stress/sleep disturbances
is hormone replacement therapy recommended for cognitive sx of menopause
no!
might even make them worse
what makes women more likely to have depressive sx
hx of PMS
stress
sexual dysfxn
physical inactivity
hot flashes
most predictive factor for menopausal dpn
prior hx of dpn
skin/hair changes related to menopause
less elastic hair
hair loss
brittle nails
facial hair
classic osteoporosis pt
post menopausal
COPD/asthma
steroids
frail/low BMI
smoker
BMD testing recs for post menopausal women
postmenopausal pt < 65 yo w. > or equal to one additional rf
all women 65 or older
should HRT be used for prevention of CHD in post menopausal women
no!
best tx for cardiovascular health for post menopausal women
lifestyle modifications
screening for what 3 cancers is recommended for post menopausal women
breast
colorectal
cervical
pharm options for menopause
HRT
antidepressants
eszopiclone (Lunesta)
antihypertensive
pregabalin
HRT options for menopause
estrogen therapy (ET)
estrogen-progesterone therapy (EPT)
bioidentical hormone therapy (BHT)
ET (unopposed estrogen) can be used for
systemically if no uterus
locally in low doses for vaginal sx
if a woman as a uterus, what type of HRT should be used
EPT
to protect against endometrial ca
absolute contraindications for HRT
thrombosis
stroke
cardiovascular events
possible contraindications for HRT based on shared decision making
undiagnosed vaginal bleeding
active DVT or PE or hx of one
arterial thromboembolic dz (MI/stroke)
liver dz
hx endometrial/breast ca
pharm for insomnia
eszopiclone (Lunesta)
