Menopause Flashcards
menopause signifies the depletion of _____ and manifest as what?
oocytes; absence of menses
what are the gonadotropin levels in pts in menopause?
elevated due to decreased estrogen levels
at what time is menopause officially diagnosed?
after 6-12 months of amenorrhea
menopause is preceded by what period?
climacteric or periomenopausal period
what is the average age of menopause in the United States?
51 y/o
t or f: cigarette smoking is a factor known to significantly increase the age of menopause
FALSE - it reduces the age of menopause (by 3 years)
t or f: genetics plays a role in the age of onset for menopause
TRUE
what is the physiology behind the perimenopausal period that invovles the oocytes dying?
the oocytes begin to die precipitously (via apoptosis) and become resistant to FSH (which is responsible for their maturity)
what happens to inhibin levels during menopause?
they are decreased because b/c it is produced in smaller amounts by fewer oocytes; (remember, inhibin inhibits FSH)
what happens with the requirement of FSH with resistant oocytes?
FSH requirements go up which triggers greater FSH release
do perimenopaual women ovulate more or less frequently? why?
less - due to shortened follicular phase (because again, fewer eggs!!) - this oligo/anovulation leads to abnormal bleeding in perimenopausal women
pain during intercourse, vaginal itching and few epithelial cells on wet mount prep is consistent with what diagnosis?
atrophic vaginitis
what is the cause of atrophic vaginitis?
decline estrogen
at what age is considered late menopause?
menopause after age 55
premature ovarian failure is defined as menopause occurring before what age?
40
what is the major estrogen circulating in menopausal women?
estrone (less potent than estradiol)
what happens to androstenedione and testosterone levels during menopause?
they fall (b/c remember these are made by the ovary)
what is the mainstay of treatment for the physiologic effects of menopause?
HRT/ER
what does decreased estradiol do to cholesterol levels? (x2)
increases LDL and decreases HDL
what effect does decreased estradiol have on the bones?
causes osteoporosis
what effect does decreased estradiol have on the vaginal mucous membranes?
atrophy and dryness
what effect does decreased estradiol have on the urethra?
loss of tone
what effect does decreased estradiol have on the psyche?
lability and depression
what effect does decreased estradiol have on the hair and skin?
skin less elastic, more wrinkled and hair reflecting more male growth patterns
when is ERT indicated?
in women post hysterectomy
what is the relationship between estrogen and blood clotting?
estrogen creates a hypercoagulble state bu increased production of hepatic coagulation factors
t or f: HRT/ERT may worsen HTN and migraines
TRUE
before HRT is initiated what test(s) should be done?
mammography
for how long is it safe for women to be placed on HRT?
5 years
t or f: HRT increases the risk of breast CA
TRUE
