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Flashcards in Menopause Deck (12):
1

Define menopause

- 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

What is the average age of menstruation

50

3

Define pathologic menopause

Gradual or abrupt cessation of menstruation before 40

4

Describe the changes in hormonal level at menopause

- 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

What hormone is measured to assess for menopause

- FSH levels are measured to determine if menopause has occurred
- Oestrogen not measured as oestrogen not only produced from the ovaries

6

List some early signs of menopause

Hot flushes, sweating, insomnia, menstrual irregularity
- Frequent headache, mood swings, irritability, depression, insomnia
- Ovaries become smaller due to decreased oestrogen production (undergo atrophy)

7

Describe why dysfunctional uterine bleeding occurs in menopause

- 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

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

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

9

Describe some intermediate changes that occur after menopause

- 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

Describe some long term changes that occur after menopause

- 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

Describe non-hormonal treatment for menopausal symptoms

- 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

List advantages and disadvantages of hormone replacement therapy

- 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