The Menopause Flashcards
What is the proper definition of menopause?
No menstrual periods for 12 consecutive months with no other biological or physiological cause
What happens in physiological menopause?
The normal decline of ovarian function
Begins between ages of 45-50 years
What is pathological menopause?
The abrupt/ gradual cessation of menstruation before 40 years
Should be investigated as this isn’t normal
What are the 4 stages of menopause?
- Pre-menopause
- Peri-menopause
- Menopause
- Post menopause
Explain what happens to hormone levels in pre- menopause
Time from age 40+ where less oestrogen is secreted
Slight rise in FSH/LH but cycle is relatively normal
Explain what happens in peri-menopause
The transition stage where physiological changes occur (mood swings, hot flushes etc)
- Follicular phase shortens
- Ovulation is early or absent
What is post-menopause?
The time after which a woman has experienced 12 consecutive months of amenorrhea
What happens to the levels of LH and FSH in menopause and why?
Normally oestrogen causes negative feedback on GnRH → low LH and FSH
In menopause- oestrogen falls below a critical point and so negative feedback is lost → LH and FSH levels rise
Which hormone is measured to diagnose physiological menopause?
FSH
Due to significantly high levels
What symptoms are associated with the early stages of menopause
- Hot flushes
- Sweating
- Insomnia
- Mood Swings
What are the consequences of oestrogen deficiency in the intermediate stage of menopause?
- Vaginal atrophy
- Skin atrophy
- Urge- stress incontinence (due to loss of muscle tone)
- Reduction in pubic hair
- Change in breast tissue
What are the consequences of oestrogen deficiency in the late stage of menopause?
- Osteoporosis
- Atherosclerosis
- Coronary Heart Disease
- CV disease
- Alzheimer’s
Why does low oestrogen cause osteoporosis?
Oestrogen inhibits osteoclast activity
Therefore, reduced oestrogen = enhanced osteoclast activity
Can lead to increased chances of breaking bones and reduced height
Why does low oestrogen cause changes to the cardiovascular system?
Low Oestrogen and Progesterone cause changes in the lipid profile → increased circulating lipids
Therefore higher risk of atherosclerosis, embolic events, MI and stroke
Why are menopausal women still susceptible to uterine carcioma?
Even though oestrogen levels are low there are still levels circulating due to testosterone underoing aromatisation
No periods= no progesterone therefore oestrogen is unopposed
Can lead to thickening and hyperplasia of the endometrium which increases risk of cancer
