Seibert - Menopause Flashcards

1
Q

menopause is defined as final menstrual period (FMP) confirmed ___ of no menstrual bleeding

A

1 year

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2
Q

average age of menopause

A

51 yo

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3
Q

classic sx of menopause

A

change in menstrual cycle

night sweats

dyspareunia

sleep disturbances

memory/concentration issues

dpn/anxiety/moodiness

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4
Q

menstrual cycle and hormonal changes that occur a few years before and 12 mo after the final menstrual period

A

perimenopause

aka the menopause transition

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5
Q

cessation of menstruation that follows bilateral oophrectomy (w. or w.o hysterectomy) or chemo/pelvic xrt or iatrogenic

A

induced menopause

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6
Q

any menopause that occurs before 40 yo - can be natural or induced

A

premature menopause

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7
Q

lifestyle factor associated w. premature menopause

A

smoking

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8
Q

the years after the FMP resulting from natural or premature menopause; ⅓ of lifespan of most North American women

A

postmenopause

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9
Q

diagnostic tests for menopause

A

low estradiol: < 20

elevated FSH: 21-100

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10
Q

FSH > __ is highly suggestive of menopause

A

30

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11
Q

what kinds of menstrual bleeding changes are common w. menopause

A

all types!

light/heavy/amenorrhea

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12
Q

abnormal uterine bleeding (AUB) includes

A

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

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13
Q

tx for vasomotor sx of menopause (ex hot flashes)

A

estrogens

progestins

clonidine

SSRIs/SNRIs

black cohosh

gabapentin

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14
Q

t/f hot flashes can also involve chills

A

T!

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15
Q

vaginal sx of menopause

A

dryness/itching/irritation

vaginal atrophy

dysuria/urge incontinence/easy bleeding

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16
Q

what vaginal sx is progressive and unlikely to resolve on its own

A

vaginal atrophy

17
Q

urinary sx related to menopause

A

urge incontinence

stress incontinence

dysuria

atrophic cystitis

18
Q

6 mc sx of menopause

A

hot flush/sweating

heart discomfort

sleep problems

dpn/anxiety

irritability

physical/mental exhaustion

19
Q

sexual health sx related to menopause

A

decreased libido

decreased estrogen/testosterone → decreased lubrication/desire

20
Q

__ increases risk for STIs in menopausal women

A

vaginal atrophy

21
Q

main sleep disturbance related to menopause

22
Q

what should you counsel women about in regards to cognitive changes of menopause

A

memory/concentration problems more likely related to normal aging/mood/stress/sleep disturbances

23
Q

is hormone replacement therapy recommended for cognitive sx of menopause

A

no!

might even make them worse

24
Q

what makes women more likely to have depressive sx

A

hx of PMS

stress

sexual dysfxn

physical inactivity

hot flashes

25
most predictive factor for menopausal dpn
prior hx of dpn
26
skin/hair changes related to menopause
less elastic hair hair loss brittle nails facial hair
27
classic osteoporosis pt
post menopausal COPD/asthma steroids frail/low BMI smoker
28
BMD testing recs for post menopausal women
postmenopausal pt \< 65 yo w. \> or equal to one additional rf all women 65 or older
29
should HRT be used for prevention of CHD in post menopausal women
no!
30
best tx for cardiovascular health for post menopausal women
lifestyle modifications
31
screening for what 3 cancers is recommended for post menopausal women
breast colorectal cervical
32
pharm options for menopause
HRT antidepressants eszopiclone (Lunesta) antihypertensive pregabalin
33
HRT options for menopause
estrogen therapy (ET) estrogen-progesterone therapy (EPT) bioidentical hormone therapy (BHT)
34
ET (unopposed estrogen) can be used for
systemically if no uterus locally in low doses for vaginal sx
35
if a woman as a uterus, what type of HRT should be used
EPT *to protect against endometrial ca*
36
absolute contraindications for HRT
thrombosis stroke cardiovascular events
37
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
38
pharm for insomnia
eszopiclone (Lunesta)