Women's Flashcards
what is menopause
permanent end to menstruation
diagnosed after a woman has had no periods for 12 months
when is the average age that women experience menopause
51yrs
what is premature menopause
menopause before the age of 40yrs. results in premature ovarian insufficiency
what is perimenopause
refers to the time around menopause where woman may be experiencing vasomotor symptoms and irregular periods
when must serum FSH test not be used to diagnose menopause
if combined oestrogen and progestogen contraception or high-dose progestogen is being used
when to consider FSH test to diagnose menopause
40-45yrs with menopausal symptoms incl, change in menstrual cycle
under 40yrs where menopause is suspected
symptoms of menopause
- change in periods - length of cycle or uterine bleeding
- vasomotor symptoms- hot flushes and night sweat
- urogenital changes - vaginal dryness and urinary frequency
- anxiety and depression
- short- term memory impairment
- joint pains
- reduced libido
what causes perimenopausal/ menopause symptoms
lack of oestrogen
how long do women need to use contraception for
2 years after last period if <50yrs
1 year after last period if >50yrs
management for menopause
HRT
CBT
antidepressants
vaginal moisturisers
vaginal oestrogen
what is atrophic vaginitis
dryness and atrophy of the vaginal mucosa due to lack of oestrogen during menopause
how does atrophic vaginitis occur
as oestrogen levels fall the mucosa becomes thinner, less elastic and drier which makes the tissue more prone to inflammation
role of oestrogen on mucosa of the vagina and urinary tract
makes it thicker, more elastic and produces secretions
clinical presentation of atrophic vaginitis in postmenopausal women
itching
dryness and discomfort
dyspareunia
recurrent UTI
bleeding due to localised inflammation
examination of labia and vagina showing atrophic vaginitis
pale mucosa
thin skin and reduced skin folds
erythema and inflammation
dryness
sparse pubic hair
management of atrophic vaginitis
vaginal lubricants
topical oestrogen - needs to be monitored due to potential risks of endometrial cancer and endometrial hyperplasia
what is bacterial vaginosis
overgrowth of bacteria in the vagina especially anaerobic bacteria leading to a fall in lactic acid producing aerobic lactobacilli which increases pH
risks of bacterial vaginosis
increased risk of STI
risk factors for bacterial vaginosis
multiple sexual partners
excessive vaginal cleaning
smoking
copper coil
clinical presentation of bacterial vaginosis
fishy smelling watery grey or white vaginal discharge
half are asymptomatic
what criteria is used to diagnose bacterial vaginosis
amsel criteria
explain criteria used to diagnose bacterial vaginosis
any 3 of the 4 needed:
- thin, white homogenous discharge
- pH of more than 4.5
- clue cells on microscopy
- positive whiff test (fishy odour)
management for bacterial vaginosis
oral metronidazole 5-7days - twice a day (400mg) or once a day (2g)
or
topical intravaginal metronidazole gel
what does bacterial vaginosis in pregnancy increase the risk of
preterm labour
low birth weight
late miscarriage
chorioamnionitis
