Postmenopause

Question 1

Name 4 side effects of HRT

Answer 1

• Unexpected vaginal bleeding
• Breast tenderness
• Peripheral oedema
• bloating
• reflux
• nausea
• mood change
• headaches

More serious ones with prolonged use include:

• Increased risk of VTE
• Increased risk of CVA
• Increased risk of breast cancer

Question 2

Name 3 absolute contraindications of HRT

Answer 2

Undiagnosed vaginal bleeding

uterine/breast cancer

acute liver disease

Established CVS disease

Previous VTE

Question 3

How does urogenital atrophy associated with menopause present?

Answer 3

Dyspareunia, dryness, pruritus, bleeding, urinary frequency, urgency, incontinence

Question 4

Name 4 things that aggravate hot flushes

Answer 4

• Caffeine
• Alcohol
• Hot drinks
• Spicy food
• Eating
• Stressful situations
• Hot climate, drugs, fatigue

Question 5

Other than being post-menopausal, name 3 other risk factors for stress incontinence

Answer 5

Pelvic prolapse, obesity, COPD, pelvic surgery, vaginal delivery, increased age, smoking

Question 6

Other than HRT, name 2 other drugs which can be used to treat vasomotor instability associated with menopause.

Answer 6

SSRIs, venlafaxine, gabapentin, propranolol, clonidine

Question 7

Which fractures are most common in post-menopausal women?

Answer 7

• hip
• forearm
• vertebral

Question 8

What lifestyle changes could the clinician encourage to decrease the risk of osteoporosis in post-menopausal women?

Answer 8

• stop smoking
• reduce alcohol intake
• maintain healthy diet and ideal body weight
• increase weight bearing exercise
• adequate calcium and vit D intake

Question 9

What is the leading cause of death in post-menopausal women?

Answer 9

CVD – need to manage cardiac risk factors!

Question 10

What are the symptoms of a cystocele?

Answer 10

• Recurrent UTI
• Urinary frequency, urgency
• Nocutria
• Positional voiding dysfunction, need to digitally manipulate mass back into vagina to pass urine