Menopause

Question 1

Premenopause?

Answer 1

Regular periods

Question 2

Perimenopause?

Answer 2

Irregular periods

Question 3

Post menopause?

Answer 3

No periods

Question 4

Average age of menopause?

Answer 4

51 years old

Question 5

Average duration of menopause symptoms?

Answer 5

7.4 years

Question 6

Average number of symptoms in menopause?

Answer 6

7

Question 7

Presentation of menopause?

Answer 7

• Most improve with time except genitourinary (dry vagina, painful sex, urinary symptoms)
• Mood swings
• Nigh sweat
• Hot flushes
• Headaches
• Lack of energy
• Recurrent UTI symptoms
• Insomnia
• Aches and pains
• Wt gain
• Dry skin and hair
• Vulvo-vaginal atrophy (VVA)

Question 8

What is vulvo-vaginal atrophy?

Answer 8

Gentitourinary syndrome of the menopause or urogenital atrophy

Question 9

Offer what to women with VVA?

Answer 9

Vaginal oestrogen and continue treatment as long as is necessary to relive symptoms

Question 10

How is menopause diagnosed?

Answer 10

-Women over 50 on Hormonal contraception who don’t want to continue until 55: routine follicle-stimulation hormone (FSH)

Question 11

FSH levels x2 (6 weeks apart) indicated for who?

Answer 11

• In women >45 with atypical symptoms

- Women between 40-45 with menopausal symptoms and/or iatrogenic amenorrhoea

Question 12

Monitoring for women under 40?

Answer 12

FSH 
E2 
TFT 
Glucose 
Prolactin 
FAI

Question 13

Treatment of menopause?

Answer 13

-HRT independent from blood results

Question 14

What can HRT increase risk of?

Answer 14

Breast cancer and VTE

Question 15

What does HRT decrease the risk of?

Answer 15

Osteoporosis

Question 16

Contraindications of HRT?

Answer 16

Breast cancer history 
CHD 
TIA or stroke 
Unexplained vaginal bleeding 
Active liver disease

Question 17

Indications for transdermal HRT?

Answer 17

-Individual peferance 
Poor symptom control with oral HRT 
GI disorder affecting oral absoprtion 
Increased VTE risk 
Variable blood pressure control 
Migraine 
Current use of hepatic inducing enzymes medication 
Gall bladder disease