Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro > Menopause > Flashcards

Menopause Flashcards

1
Q

What is menopause?

A

Permanant cessation of menstruation resulting from the loss of ovarian follicular activity

12 consecutive months of amenorrhoea with no other signs of pathological or physiologcal cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is climacteric or perimenopause?

A

Regression of ovarian function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Menopause transition - what is it?

A

Time between onset of irregular menses and permanent cessation of menstruation (average is 4 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is early menopause?

A

Menopause that occurs well below the average of natural menopause (before 45)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is premature menopause?

A

Cessation of menstruation due to depletion of ovarian follicles before age of 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is surgical menopause?

A

Permanent cessation of menstruation after bilateral oophorectomy (ovary removal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Normal ages of menopause

A

Decline in ovarian function begins between 45-55 (average 51)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is pathological menopause?

A

Gradual or abrupt cessation of menstruation before age 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 phases of menopause

A

Pre-menopause (may be slight FSH/LH changes but cycle normalish)

Perimenopause (transition, things start to happen to cycle)

Menopause

Post menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pre-menopause explained

A

From 40+ years
Slightly less oestrogen
LH and FSH levels rise (FSH more)
May be some reduced fertility but cycle still relatively normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Perimenopause explained

A

Transition phase
Physiological changes associated with end of reproductive capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phase changes in perimenopause

A

Follicular phase shortens
Ovulation early or absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Post menopause explained

A

Time after woman has experienced 12 consecutive months of amenorrhoea (no menstruation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens to ovarian function as menopause begins?

A

Production of oestrogen decreases as the number of primordial follicles approach 0

When oestrogen falls below critical value oestrogen no longer inhibits LH and FSH and these rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens to quantity and quality of of oocytes as you age?

A

Number decreases and so does quality (not many ‘good’ eggs left)
Increase in miscarriage risk and genetic abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Perimenopause hormones

A

Can be only slightly different to normal - diagnose with symptoms rather than blood levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens to FSH and LH in menopause?

A

Levels rise due to no negative feedback from oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the cause of menopause then?

A

Ovaries are depleted of follicles
No amount of FSH and LH can make them work
Oestrogen falls dramatically
FSH and LH rises (no inhibin or -ve feedback)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diagnosing menopause and perimenopause

A

Can diagnose WITHOUT lab tests in healthy women aged over 45 with menopausal symptoms

perimenopause - vasomotor symptoms and irregular periods

Menopause - not had a period in last 12 months and not using hormonal contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is a FSH test used?

A

In younger women - aged 40-45 with menopausal symptoms

Under 40 whom menopause is suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When to not use FSH test?

A

do not use in women using oestrogen and progesterone contraception

Women 45 and above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to diagnose premature ovarian insuffiency?

A

Women below 40
Menopausal symptoms and elevated FSH levels on TWO blood samples taken 4-6 weeks apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Early consequences of oestrogen deficiency

A

Hot flushes
Sweating
Insomnia
Menstrual irregularity
Psychological symptoms (mood, anxiety, depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Intermediate oestrogen deficiency consequences

A

Vaginal atrophy
Skin atrophy
Urge-stress incontinence
Dyspareunia (painful sex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Late oestrogen defiency consequences

A

Osteoporosis
Atherosclerosis
Coronary heart disease
Cardiovascular disease
Alzheimer’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Symptoms of menopause

A

Vasomotor - hot flushes/night sweats
Change to menstrual pattern
Cognitive impairment and mood disorders
Altered sexual function (decreased libido and painful)
Sleep distubance
Skin and hair changes (thinning/falling out)
Joint and muscle pain
Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Vasomotor symptoms of menopause description

A

Sudden transient sensation of warmth to intense heat over face, chest, neck and head followed by profuse perspiration

28
Q

Duration of vasomotor symptoms

A

Few seconds to several minutes

29
Q

Frequency of vasomotor symptoms

A

Rare to every few minutes
More at night or during stress

30
Q

What causes the vasomotor symptoms?

A

Pulsatile release of GnRH

31
Q

How long do vasomotor symptoms last during menopause?

A

Improve within few months (30-50%)

Resolve within 4-5 years (85-90%

25% persist more than 5 years

32
Q

What helps vasomotor symptoms?

A

90% of cases - exogenous oestrogen and progesterone relieve symptoms

33
Q

What changes can occur in menstrual pattern in women through menopause?

A

Dysfunctional:
Spotting between periods
Heavy bleeding
Mid cycle bleeding
Irregular cycles

34
Q

What causes changes to menstrual pattern in menopause?

A

the endometrium to keep thickening - hyperplasia

Changes in oestrogen causes:

Late menstrual period and irregular bleeding and spotting

No corpus luteum = no progesterone and increased risk of carcinoma (unopposed oestrogen)

35
Q

Psychological changes in menopause

A

Irritability
Confusion
Lethargy
Memory loss
Loss of libido
Depression

(Trial HRT before antidepressants)

36
Q

Changes to skin in menopause

A

Loses elasticity
Becomes thin and fine from loss of elastin and collagen

37
Q

Changes to weight during menopause

A

Weight increase more likely - irregular food habits and mood changes
More fat deposit around hips, waist and buttocks

38
Q

Changes to hair during menopause

A

Dry and coarse
Hair loss due to decreasing oestrogen

39
Q

Voice changes in menopause

A

Deeper due to thickening of vocal cords

40
Q

Menopause effects on Gi tract

A

Motor acitivity diminished - constipation

41
Q

Menopause effects on urinary system

A

Tissue lining urethra and bladder becomes drier, thinner and less elastic

Incontinence

Loss pelvic tone

Reduced elasticity of bladder - frequency and urgency (nocturia, dysuria)

Increase suceptibility of UTI

42
Q

Changes in vagina in menopause

A

Absence of oestrogen = thinning of vaginal skin (painful sex and bleeding)

Lack of glycogen - rise in vaginal pH and increase risk of infection

43
Q

Treatment of changes to the genitals during menopause

A

Topical oestrogen (creams/gels)

44
Q

What happens to the uterus during menopause?

A

Can become small and fibrotic due to atrophy of muscles
Endometrium regresses
Myometrium shrinks
Cervix thins

45
Q

Breast changes in menopause

A

Low oestrogen = decrease fat and tissue, shrinks
Breasts sag as lose elasticity

46
Q

Bone changes in menopause

A

Calcium loss from bone increases
Bone mass reduces
–> osteoporosis (low oestrogen enhances osteoclast absorption of bone)

47
Q

Why give HRT for bone reasons?

A

Can be considered in younger postmenopausal women to reduce risk of osteoporotic fractures

48
Q

Menopause effect on coronary heart disease

A

Unusual before menopause - oestrogen protective?
Risk increases massively post menopause (by 60 almost same risk as men)

49
Q

Another reason for increased risk of coronary heart disease

A

Obesity, hypertension and high cholesterol is seen around menopause

50
Q

is HRT recommended for CHD protection?

A

No - cardiac protection HRT was not found to be beneficial - HERS trial

51
Q

Lifestyle advice menopause

A

Regular exercise
Sleep hygiene
Light weight clothing, sleep in cooler room
Avoid triggers - spicy foods, caffeine, smoking and alcohol

52
Q

Contraceptive advice for women in menopause

A

Need contraception until periods have stopped for 1 year if over 50 or 2 years if under 50

53
Q

Treatment for vasomotor or mood disorders associated with menopause

A

Oral or transdermal (patch or gel) HRT

54
Q

What must HRT (oestrogen) therapy be given with?

A

Oestrogen must be given with progesterone if woman has uterus (otherwise endometrium thickens from hyperplasia and increase risk of cancer)

If no uterus, can just have oestrogen

55
Q

Treatment for urogenital symptoms associated with menopause

A

Low dose vaginal oestrogen cream (estriol cream)

56
Q

Example of HRT

A

Evorel conti

57
Q

Benefits of HRT

A

Reduced vasomotor symptoms
Improvement of mood
Improvement of urogenital symptoms
Reduced osteoporosis risk
Lower risk of colorectal cancer
Muscle mass - for strength and connective tissue

58
Q

BEST benefit of HRT

A

Improved quality of life - 1/3 women quit jobs during menopause

59
Q

Risks of HRT

A

Venous thromboembolism
Coronary heart disease
Breast cancer

60
Q

VTE HRT risk explained

A

ONLY WITH ORAL HRT
transdermal is no greater than baseline

61
Q

Coronary heart disease HRT risk explained

A

If you start HRT before 60 - no increase risk of CV disease

HRT tablets (oral) slightly increase risk of stroke (but low under women in 60 anyway)

62
Q

Breast cancer risk HRT info

A

Oestrogen only HRT causes little/no change

HRT that contains both oestrogen and progesterone may increase breast cancer risk - risk may be higher if take for longer but falls when stop taking

63
Q

Advantages and disadvantages of oral HRT

A

A - Cheap and effective

D - First pass metabolism, variable plasma levels, higher doses needed

64
Q

Advantages and disadvantages of transdermal HRT

A

A - avoids first pass metabolism, reduced risk of VTE, continuous administration

D - cost, skin reactions

65
Q

Advantages and disadvanatges of vaginal HRT

A

A - good for urogenital symptoms, minimal systemic absorption, can use for 3 months without progeterone opposition

D - unlikely to treat other symptoms

66
Q

Mirena intrauterine system advantages and disadvantages

A

A - licensed for 4 years to provide progesterone arm of HRT and contraception

D - only provides progesterone part and contraception, need oestrogen part too (oral or transdermal)

67
Q

Oestrogen effects on osteoclasts

A

Oestrogen inhibits osteoclastic bone-resorbing activity and promotes osteoclast apoptosis.

Repro (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions