Menopause Flashcards
(37 cards)
If a patient is over 50, low long does amenorehea be present for a diagnosis
1 year
If a patient is under 40, low long does amenorehea be present for a diagnosis
2 years
What happens in the oestrogen and progesterone levels
Decline
Are LH and FSH high
Nope they are low due to the absence of negative feedback from oestrogen
(Usually oestrogen suppresses production of these two hormones)
True or false
In perimenopause the women may be experiencing vasomotor symptoms and irregular periods
Physical symptoms of menopause
Hot flushes
Night sweats
Joint and muscle pain
Palpitations
Skins and hair changes
Weight gain
Psychological symptoms
Cognitive disturbances
Sleep disturbances
Tired
Lack of energy
Anxiety
Gynaecological symptoms
Low libido
Vaginal dryness
Menstrual irregualties
Urinary incontinence
Non hormonal treatment for vasomotor symptoms
SSRIs
Gabapentin
Clonidine
CBT
First line for vasomotor symptoms
HRT
If patient has no uterus or has a mirena what do you give
Oestrogen only
If patient does have a uturus or no mirena what do you give
Oestrogen and progesterone
Regarding oestrogen and progesterone therapy
Who requires sequential (cyclical combined)
Perimenopausal women who are still mensturating or within 12 months of last period
Cyclic - progesterone trigger bleed
Regarding oestrogen and progesterone therapy
Who requires continuous combined
Postmeopausal - more than 12 months post menopause
List the treatments of oestrogen only
Oral
- elleste solo
Transdermal
- evorel
List the treatments of oestrogen and progesterone - sequential combined
Oral
- Ellet’s duet
Patch
- evorel sequi
How does the sequential (cyclical) combined therapy work for Ellet’s duet (oral)
Pack contain 28 tablets
14 tabs - contain oestrogen only - taken for the first 14 days
14 tabs - contain progesterone and oestrogen - taken for the last 14 days
How is oestrogel applied (for women requiring oestrogen only)
Apply to the arms or thighs to dry skin OD
List the treatments of continuous combinned
Transdermal - evorel conti
Oral - kilofem
ADRs
Headaches
Breast pain/tenderness
Leg cramps
Diarrhoea
Bloating
Unexplained vaginal bleeding
HRT - CI
Breast cancer - past or present
Undiagnosed vaginal bleeding
Oestrogen dependent cancer
VTE, unless on anticoagulant
Angina or mi
Pregnancy
Liver disease
HRT - risks
Breast, ovaries, endometrial cancer
VTE Angina
CVD
Stroke
Who may benift from transdermal
Trouble with oral
Hx or VTE
CVD risk - obesity, HTN
GI disorder
Migraines
Lactose sensitivity (most oral contain lactose)
Coucell on the use of HRT
Apply on dry clean skin - lower abdomen or outer thigh
Rotate site of the patch
Change on the same days each way
If patch falls off - replace with a new one
Avoid very hot water when showering
