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Flashcards in Menopause Deck (26)
1

What are the health risks associated with menopause?

CVD (total LDL levels rise), osteoporosis, urogenital atrophy (pee issues), quality of life

2

What is the ave age of menopause in USA

52

3

What happens in ovarian development in week 4 of the fetus

-Appearance of primordial germ cells in yolk sac
-Migration of germ cells to genital ridge
-Germ cell mitosis

4

What happens in ovarian development in week 6 of the fetus

-Germ cells arrive at genital ridge
-Sex cord formation supports germ cells

5

What happens in ovarian development in week 8-12 of the fetus

-Ovarian differentiation
-Reproductive tract differentiation
-Initiation of meiosis
-oogonia become oocytes
-Meiotic arrest in P1

6

What happens in ovarian development in weeks 16-20 of the fetus

-Ovarian follicular formation
-Max oocyte number achieved (5-7 million)

7

What happens in the ovary in prepubescent state?

-Waves of follicular development and atresia
-No stimulation of ovary by pituitary gland
-Minimal estrogen production
-No ovulation occurs

8

How many germ cells does a female have by puberty?

300,000-500,000

9

About how many oocytes are selected to ovulate

400-500 (most undergo atresia)

10

Describe the rate of follicular atresia

Not fixed, becomes more rapid 10-15 years before menopause

11

Define menopause

The point in time when permanent cessation of menstruation occurs following the loss of ovarian activity (naturally or surgically)

-This is a retrospective diagnosis (12 mo w/o pd)
-FSH and LH are high, low estrogen

12

What is perimenopause

Time with menstrual irregularity and symptoms

13

What factors are related to age of onset of menopause

-Smoking dec age by 1.5yrs
-Family trends
-Dietary habits (veg younger than meat)
-Alcohol consumption and later

14

What is the health risks associated with perimenopause and post menopause?

metabolic syndrome

15

What are the menopausal symptoms?

Hot flash, urogential atrophy, muscoluskeletal symptoms, disordered sleep, mood (inc and exacerbated mood disorders)

16

What does smoking do to estrogen metabolism

Increases it! Thats why you hit menopause earlier and have more symptoms when you smoke

17

What are some risk factors for dev menopausal symptoms?

Smoking, african american, obesity

18

Treatment of menopausal symptoms

-Hormone replacement therapy
-SSRIs
-Antihypertensives
-Behavioral: diet, wt loss, dec smoking etc

19

What is the prev of premature ovarian insufficiency?

1%/year

20

What is premature ovarian insufficiency?

Cessation of ovarian fxn at or before 40y/o

21

How do you diagnose premature ovarian insufficiency?

High FSH/LH and concurrent low estradiol on two sep occasions at least 1 mo apart

22

Etiology of premature ovarian insufficiency?

-Genetics
-Autoimmune attack on ovaries
-Metabolic disorders
-Iatrogenic exposures (chemo etc)
-Smoking

23

Describe a genetic abnormality that leads to premature ovarian insufficiencey

Turner's Syndrome, 45X-->premature ovarian failure and delayed puberty, both X chromosomes are req to be active in the ovary to ensure normal dev and maintenance of oocyte number. Get rapid atresia of oocytes.

24

Describe how chemo/radiation lead to premature ovarian insufficiencey

Effects of chemo/radiation depends on age of pt at time of exposure, treatment field, type, dose, duration

-Chemo causes damage to primordial follicles, alkylating agents are particularly damaging

-Radiation to the pelvis=more damaging due to scatter

25

What is a treatment option for premature ovarian insufficiencey

Hormone replacement therapy, fertility preservation in those treated for cancer (like IVF or oophoropexy where ovaries are surgically moved away from radiation field)

26

What is important to know about ovulation and menopause

Menopause has nothing to do with ovulation!