Menopause

Question 1

30% of premature menopause is caused by

Answer 1

surgery (hysterectomy)

Question 2

Median and age range of menopause

Answer 2

median: 51.4
range: 48-55

Question 3

Median for perimenopause

Answer 3

47.5 years, for 4 years

Question 4

The physiologic period of a woman’s life during which there is regression of ovarian function

Answer 4

Climacteric

Question 5

Menopause is the permanent cessation of menstruation caused by the failure of ovarian follicular development DESPITE WHAT

Answer 5

Despite the presence of adequate gonadotropin stimulation

Question 6

Examples of iatrogenic menopause

Answer 6

surgical, radiation therapy, chemotherapy

Question 7

______ # follicles at birth, _____# remain at menopause

Answer 7

1 million at birth

1,000 remain at menopause

Question 8

Which estrogen (is still dominant but) decreases secretion during perimenopause

Answer 8

Estradiol

Question 9

In addition to estradiol, the production of what essential “hormone” decreases with perimenopause

Answer 9

Inhibin

Question 10

What will happen if, in each cycle, inhibin secretion

gets lower and lower?

Answer 10

Inhibin’s job is to inhibit secretion of FSH and LH.

Without it, the feedback on the hypothalamus and pituitary is hindered, and FSH and LH remain high.

Elevations of FSH, particularly at the beginning of a cycle, are predictive of perimenopause and of the fertility of remaining ova.

Question 11

Where is inhibin produced

Answer 11

Gonads, pituitary gland, placenta, corpus luteum, etc

FSH stims secretion of inhibin from granulosa cells of ovarian follicles

Question 12

By what age does risk of spontaneous abortion rise to 50%

Answer 12

45

Question 13

At menopause the ratio of estrogen to androgen ___

Answer 13

decreases

Question 14

At menopause, sex hormone - binding globulin secretion __-

Answer 14

decreases

Question 15

At menopause, peripheral aromatization of DHEA to estrone ___

Answer 15

INCREASES

Question 16

At menopause, E2 : E1 ratio

Answer 16

decreases

Question 17

At menopause, circulating bioavailable testosterone ___

Answer 17

stays the same

Question 18

Which cells in ovarian follicles make estrogen

Answer 18

Granulosa and Thica cells (which degenerate during menopause)

Question 19

Which menopausal changes can lead to defeminization, hirsutism , mild degrees of virilism… even voice deepening.

Answer 19

↑ circulating levels of 5-DHT due to changes in binding proteins in the bloodstream

Question 20

E3

Answer 20

Estriol (placental)

Question 21

E2

Answer 21

Estradiol - predominant thru fertile period

Question 22

E1

Answer 22

Estrone - predominant in menopause, produced in peripheral fatty tissue

Question 23

urgency, frequency, dysuria and suprapubic pain in the absence of a UTI

Answer 23

Atrophic urethritis

Question 24

urge incontinence, frequency, dysuria, and nocturia

Answer 24

Atrophic cystitis

Question 25

Three most common fractures in postmenopausal women

Answer 25

vertebrae distal radius neck of femur