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Flashcards in Menopause Deck (28):
1

wat is climacteric menopause

the bit leading up to the last period

2

what is the average age of menopause

51

3

when is early menopause

<45 years

4

when is premature menopause

<40 years

5

when is late menopause

>54

6

what are some causes of premature menopause

genetic
chromosomal
radio/chemo
removal of ovaries due to endometriosis

7

how many ova at birth

1 million

8

what does FHS and LH from the ant pit do

cause granulosa cells to secrete oestrogens

9

what are oestrogens

collection of oestrogen like hormones such as estrodial

10

what leads to menopause

absence of oestrogens

11

what are some effects of oestrogen

secondary sexual characteristics
hair distribution, body shape and fat distribution
effect on collagen
bone growth
proliferates endometrium

12

what are the three ways menopause can be diagnosed

symptoms
pattern of periods
blood tests - FSH and LH

13

how is FSH and LH released

can a blood test for FHS and LH levels diagnose menopause

when is FHS and LH raised

released in pulsatile fashion

single raised levels do not confirm diagnosis, maybe is women has no uterus but not in isolation

raised poor to ovulation, stopping COCP or depo, raised breastfeeding or certain medication (SSRI)

14

what are some physical symptoms

hot flushes
night sweats
palpitations
insomnia
joint aches
headaches

15

how many women have hot flushes
how many have severe symptoms
how long do they last
how long does each one last for

60-80%
20%
2 years but 10% for 15 yrs
last 3-5 minutes

16

what are hot flushes triggered by

anxiety, hot meals, change in temperature of the room or no trigger

17

what are some psychological symptoms

mood swings
irritability
anxiety
difficulty concentrating
forgetfulness

18

sexual symptoms of menopause
why do these occur

vaginal dryness due to withdrawal of oestrogen

reduced libido due to physical symptoms

libido can be stimulated by testosterone

19

what are some later symptoms

frequency
recurrent UTIs
dysuria
incontinence
dry hair and skin
atrophy of breast and genitals

20

what is perimenopausal DUB

irregular periods because eggs aren't being released regularly anymore

21

when does PMB occur
what should be done and why

bleeding a year after menopause

nees to be investigated with a pipelle biopsy as could be ovarian cancer

22

conservative management of menopause

diet - processed food makes symptoms worse
weight loss
exercise - reduces symptoms
lifestyle
caffeine

23

menorrhagia treatment

mefanamic acid is a NSAID reduced blood supply to the uterus

tranexamic acid anti fibrinolytic

progesterones - stabilises the lining of the womb and so its less likely to proliferate DEPO

IUS - releases low dose prog and is a contraceptive

endometrial ablation

hysterectomy

24

HRT

oestrogen alone - can cause endometrial hyperplasia or endometrial cancer - so only if hysterectomy

oestrogen and progesterone - increases risk for breast cancer compared to oestrogen alone

topical and oral

25

benefits for HRT

reduced osteoporotic fracture
reduced bowel cancer

26

risks for HRT

VTE
CVA
breast cancer
gallbladder disease

27

non HRT treatments

clonidine
SSRIs
regelle
Yes
sylk

28

when are non HRT treatments used

second line to HRT if breast cancer