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3 - Reproduction > Menopause > Flashcards

Flashcards in Menopause Deck (12)
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1
Q

Define menopause

A
  • Permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity
  • Need 12 consecutive months of no menstrual periods and no biological or physiological cause can be identified
2
Q

What is the average age of menstruation

A

50

3
Q

Define pathologic menopause

A

Gradual or abrupt cessation of menstruation before 40

4
Q

Describe the changes in hormonal level at menopause

A
  • Oestrogen levels begin a gradual decline at 40 as the number of primordial follicles approaches zero
  • When oestrogen levels fall below a critical level, then it fails to negatively feedback and therefore LH and FSH levels rise
    • FSH always higher than LH
  • GnRH levels also rise at menopause due to no oestrogen feedback
5
Q

What hormone is measured to assess for menopause

A
  • FSH levels are measured to determine if menopause has occurred
  • Oestrogen not measured as oestrogen not only produced from the ovaries
6
Q

List some early signs of menopause

A

Hot flushes, sweating, insomnia, menstrual irregularity

  • Frequent headache, mood swings, irritability, depression, insomnia
  • Ovaries become smaller due to decreased oestrogen production (undergo atrophy)
7
Q

Describe why dysfunctional uterine bleeding occurs in menopause

A
  • Continued oestrogen causes the endometrium to keep thickening
  • Leads to a late menstrual period followed by irregular bleeding and spotting
  • Greater thickening of uterine wall
  • No ovulation means no corpus luteum and therefore no progesterone production
  • Increased risk of carcinoma - unopposed oestrogen (progesterone acts to control uterine wall development from oestrogen)
8
Q

Why should oestrogen-only hormone therapy only be give to women who have had a hysterectomy

A

Women who have uterus have risk of developing uterine carcinoma due to unopposed oestrogen

9
Q

Describe some intermediate changes that occur after menopause

A
  • Skin loses its elasticity and becomes thin and fine
  • Weight increase - irregular food habit due to mood swings
    • Increased deposition of fat around hips, waist and buttocks
  • Hair - dry and brittle
  • Voice - become deeper due to thickening of vocal cords
  • Digestive and urinary system
    • Digestive tract diminished after menopause
    • Urinary incontinence
  • Breast - becomes flat and shriveled
10
Q

Describe some long term changes that occur after menopause

A
  • Bone - calcium loss from the bone leads to loss of bone density
    • Oestrogen normally inhibits osteoclasts, therefore increased osteoclasts leads to increased recycling of bone
    • Predisposes to osteoporosis
  • CVS system - increased circulating levels of lipids
    • Hyperlipidaemia can predispose to atherosclerosis
    • Gradual rise in the risk of heart disease and stroke
11
Q

Describe non-hormonal treatment for menopausal symptoms

A
  • Dressing in light layers can alleviate hot flashes and night sweats
  • Avoid caffeine, alcohol and spicy food
  • Reducing dietary fat intake and regular exercise can reduce weight gain
12
Q

List advantages and disadvantages of hormone replacement therapy

A
  • Advantages of HRT
    • Minimizes menopause symptoms
    • Improve well-being
    • Can limit osteoporosis
  • Disadvantages of HRT
    • Increased risk of blood clots
    • Risk of heart disease
      • Risk of breast cancer