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Flashcards in Menopause Deck (27)
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1
Q

Natural Menopause

A

permanent cessation of menstrual periods, determined RETROSPECTIVELY, after a woman has experienced 12 months of amenorrhea with out any pathological or physiological cause

2
Q

Median age of menopause

A

51.4

3
Q

Ovarian follicular depletion results in this during menopause

A

HYPOestrogenemia and HIGH follicle stimulating hormone (FSH) concentrations

4
Q

Primary ovarian insufficiency

A

menopause before age 40, also called premature ovarian failure- considered to be abnormal

5
Q

Perimenopause - when and what are the s/s

A

after the reproductive years but before menopause usually 4 years before the last menstrual period – characterized by irregular menstrual cycles, endocrine changes and hot flashes, sleep disturbances, mood symptoms, vaginal dryness, and changes in lipids and bone loss

6
Q

Most common menopausal symptom

A

hot flashes seen in up to 80 percent of women

7
Q

Late reproductive years s/s

A

serum inhibin B decreases, FSH increases slightly, estradiol is preserved, luteal phase progesterone declines as fertility potential declines. follicular phase before ovulation SHORTENS. Typically in their 40s.

8
Q

Perimenopause s/s and age of onset

A

ovarian follicular depletions leads to a change in intermentrual interval (lengthened) cycle usually 25-35 days between but now 40-50 days. and a change in bleeding pattern, and hormonal s/s. Usually age 47. FSH > 25 but will fluctuate

9
Q

Late transition

A

one to three years before the final menstrual period, lengthened intermentrual interval with skipped cycles, amenorrhea episodes, and an increased in anovulatory cycles

10
Q

the more irregular the cycle the more dramatic fluctuation in

A

FSH and estradiol, may be high FSH with menopause but then a return to normal premenopausal range

11
Q

Increase risk of what during the year leading to the final menstrual period

A

accelerated bone loss, cardiovascular risk. With 3 months of amenorrhea can expect their FMP within the next 4 years.

12
Q

Hallmark s/s of perimenopause and menopause

A

hot flash, also a/w new onset depression, vaginal dryness and sleep disturbances

13
Q

Hot flashes sensation

A

heat on the upper chest and face, rapidly becoming generalized 2-4 mins with profuse sweating, palpitations, anxiety. can have one per hour each day, very common at night. untreated stop within 4-5 years of onset.

14
Q

Sleep disturbances

A

arousal from sleep from hot flashes

15
Q

Anxiety/depression

A

can lead to sleep disturbances as well. can also have restless leg or sleep apnea.

16
Q

Depression risk

A

significant increase risk of new onset depression during menopausal transition. perimenopausal 2.5x more likely than premenopause – estrogen therapy to treat

17
Q

Vaginal dryness

A

epithelium of vaginal walls is estrogen dependent and deficiency leads to thinning and dryness – vaginal atrophy, on exam vagina will appear pale. can be itchy and women often experience dysparenia

18
Q

Sexual function

A

estrogen deficiency leads to decrease in blood flow to the vagina and vulva, leads to decrease vaginal lubrication and sexual dysfunction, vagina may lose elasticity and become shorter – responds to estrogen therapy, also cervix can atrophy and become flush with the top of the vaginal vault

19
Q

Cognitive changes

A

memory loss, difficulty concentrating, estrogen beneficial in cognitive function

20
Q

caution

A

not totally protected from pregnancy until amenorrhea for >12 mos or CONSISTENTLY elevated FSH >30

21
Q

not all hot flashes are from estrogen deficiency- other differentials?

A

pheochromocytoma (worst it could be)
leukemia’s
thyroid malfunction
psychosocial symptoms

22
Q

first measurable sign of reproductive ageing

A

FSH elevation >10 IU/L in early follicular stage (days 2- 5 of the mentrual cycle)

23
Q

most follicular loss results from what?

A

atresia, NOT ovulation

24
Q

climacteric

A

phase in a women’s aging process marking the transition from reproductive to non reproductive states, is a process, not a point in time

25
Q

vasomotor symptoms

A

aka hot flashes, hallmark sx of perimenopause/ climacteric, worse at night, interrupts sleep. can continue even in post- menopause

26
Q

making the definitive diagnosis of menopause

A

no ONE test, woman has reached menopause when FSH are consistently >30 (caveat- levels often inconsistent for a temporary span of time)

27
Q

if dx of menopause is not clear..

A

Rule out other DD