Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gaby’s NICE > Menopause > Flashcards

Menopause Flashcards

(43 cards)

Start Studying
1
Q

What are the main symptoms of menopause?

A
  1. Menstrual cycle change
  2. Vasomotor: hot flushes, sweats
  3. Genitourinary: dryness
  4. Mood: depression
  5. Musculoskeletal: joint & muscle pain
  6. Sexual difficulties: low libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

At what age is early menopause?

A

40-44

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

When is perimenopause identified without lab tests?

A

Age >45
Vasomotor Sx with any change in menstrual cycle

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

When is menopause diagnosed without lab tests?

A

Age > 45
No period for > 12 months with no hormonal contraception

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

Which lab tests are not used to identify perimenopause or menopause?

A
  1. AMH
  2. Inhibin A
  3. Inhibin B
  4. Oestradiol
  5. Antral follicle count
  6. Ovarian volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In whom is FSH used to confirm menopause?

A
  1. Age 40-45 with menopausal Sx inc change in cycle
  2. Age < 40 with suspected POF
  3. Provided not on combined or high prog contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

For what aspects of HRT should the benefits & risks be discussed?

A
  1. Combined vs oestrogen-only
  2. Transdermal vs oral
  3. Types of oestrogen & prog
  4. Sequential vs cont combined
  5. Dose & duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which complementary therapies have evidence of helping vasomotor Sx?

A
  1. Black cohosh
  2. Isoflavones
  3. St John’s wort but caution in breast Ca & drug interactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In what forms can vaginal oestrogen be prescribed?

A
  1. Cream
  2. Gel
  3. Tablet
  4. Pessary
  5. Ring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What alternatives to vaginal oestrogen can be used for genitourinary menopausal Sx?

A
  1. Non-hormonal moisturisers & lubricants
  2. Prasterone: PV DHEA
  3. Ospemifene: PO SERM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What special considerations are there for breast cancer without menopausal genitourinary Sx?

A
  1. Try non-hormonal Tx first
  2. With previous hx consider adding PV oestrogen, little is absorbed
  3. With current aromatase inhibitors, work with Ca specialist
  4. PV oestrogen probably safe with ER -ve breast Ca
  5. Tamoxifen probably reduces impact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What treatment can help with menopausal low sexual desire?

A

Testosterone

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

What are the considerations for HRT with VTE risk?

A
  1. Increased risk eg BMI >30: transdermal rather than oral
  2. High risk eg strong FHx or hereditary thrombophilia: involve haematologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which patients might need a menopause expert for HRT decisions?

A
  1. Personal hx CHD or stroke
  2. Personal hx or high risk breast Ca
  3. Those who have taken gender-affirming HRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the overall impact of HRT on life expectancy in > 45s?

A

Likely none

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

Which type of HRT is given to women with a uterus?

A

Combined

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

What specific health outcomes are affected by combined HRT?

A
  1. Breast cancer
  2. Endometrial cancer
  3. Ovarian cancer
  4. Coronary heart disease
  5. Dementia
  6. Muscle mass & strength
  7. Osteoporosis
  8. Stroke
  9. T2DM
  10. VTE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the impact of combined HRT on breast cancer?

Study These Flashcards
A
  1. Increases risk, with increasing duration of use, normalising 10y after stopping
  2. V small increase in risk of death from breast Ca
  3. Sequential combined better than continuous combined
19
Q

What is the impact of combined HRT on endometrial cancer?

Study These Flashcards
A
  1. Continuous combined decreases risk
  2. Sequential combined may slightly increase risk
20
Q

What is the impact of combined HRT on ovarian cancer?

Study These Flashcards
A
  1. Very slight increased risk
  2. On very low baseline in <60
21
Q

What is the impact of combined HRT on coronary heart disease?

Study These Flashcards
A
  1. Does not increase risk of disease
  2. Does not increase mortality from CVD
22
Q

What is the impact of combined HRT on dementia?

Study These Flashcards
A

Might increase risk if started > 65

23
Q

What is the impact of combined HRT on muscle mass & strength?

24
Q

What is the impact of HRT on osteoporosis?

Study These Flashcards
A
  1. Baseline risk is low
  2. Risk of fragility fracture improved whilst on Tx
25
What is the impact of HRT on stroke?
1. Baseline risk in <60 is v low 2. Transdermal unlikely to increase risk 3. Oral increases risk, more so in black people
26
What is the impact of combined HRT on T2DM?
No increase in risk
27
What is the impact of combined HRT on VTE?
1. Transdermal doesn’t increase risk 2. Oral increases risk
28
What is the impact of oestrogen-only HRT on breast cancer?
Little or no increase
29
What is the impact of oestrogen-only HRT on endometrial cancer?
Increases risk in those with a uterus, however taken
30
What is the impact of oestrogen-only HRT on ovarian cancer?
Increases risk very slightly, low baseline risk <60
31
What is the impact of oestrogen-only HRT on coronary heart disease?
Does not increase risk of disease or mortality
32
What is the impact of oestrogen-only HRT on dementia?
Unlikely to affect
33
What is the impact of oestrogen-only HRT on muscle mass & strength?
May improve
34
What is the impact of oestrogen-only HRT on osteoporosis?
Decreases fragility fracture risk whilst taking
35
What is the impact of orstrogen-only HRT on stroke?
1. Risk increases with oral 2. Unlikely to increase with transdermal
36
What is the impact of oestrogen-only HRT on T2DM?
Doesn’t increase risk
37
What is the impact of oestrogen-only HRT on VTE?
1. Risk increased with oral 2. Risk not increased with transdermal
38
How is premature ovarian insufficiency diagnosed?
1. Menopausal Sx, including no or infrequent periods 2. In under 40 years old 3. With elevated FSH on 2 samples, 4-6 weeks apart
39
How should premature ovarian insufficiency be managed?
1. HRT or 2. Combined contraception 3. Until at least natural age of menopause 4. For bone & cardiovascular health 5. Consider psychosocial health
40
How should PV bleeding when starting HRT be managed?
1. Common side effect for 3 months 2. Medical attention after this
41
How should HRT be stopped?
1. Can gradually reduce to limit recurrence of Sx 2. Or stop immediately, o difference long-term
42
When should HRT be reviewed?
1. At 3 months for tolerability & efficacy 2. Annually thereafter
43
What proportion of women experience a) POF, b) early menopause
a) 1% b) 3-8%

Gaby’s NICE (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions