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Flashcards in menopause and endometriosis Deck (27):
1

perimenopause

time leading up to menopause
when ovarian function and hormone production are declining, but have not yet stopped

2

menopause

permanent cessation of menstrual cycle

3

premature menopause

menopause occurring before 40

4

changes that occur with menopause

vasomotor symptoms
sleep quality
mood changes
urogenital symptoms
sexual well being
skin changes

5

decreased E

vasomotor symptoms
UG disorders
CHD risk factor (lipids)
skin changes
associated with CV disease, bone loss/osteoporosis

6

decreased P

irregular periods
PMS

7

decreased androgen

decrease in mood
diminished energy
impaired sexuality
mm weakness
osteopenia

8

what happens when HT is initiated within 5 years of onset of menopause?

does NOT increase CHD risk

9

what happens if HT is initiated years after menopause?

HT does not prevent and may actual increase risk of CHD

10

risks of HT

VTE- rare
greatest risk within first year of use

11

diseases associated with menopause

CHD
osteoporosis
breast CA
colon CA
dementia

12

transdermal administration of HT

seems to not have an increased risk of VTE

13

treating moderate-severe vasomotor symptoms

HT gold standard
SSRIs and Gabapentin
Progestogens (need large dose)
clonidine

14

what if pt cannot take E

bisphosphonates or SERMs
Vit D, Ca

15

Dx endometriosis

laparoscopy +/- Bx

16

triad of endometriosis

dysmenorrhoea
dyspareunia
infertility

17

other symptoms of endometriosis

pre menstrual staining
pain with defaecation during menses
intermenstual pain
disordered cycles
FHx

18

Ddx for endometriosis

primary dysmenorrhoea
IBS
ovulation pain
PID
psychosexual problems

19

predisposing factors for endometriosis

FHx
disordered immunity
environmental toxins
recurrent ovulation
infertile partner
obstructed menstrual flow

20

Tx of endometriosis

pain- Rx
infertility- Surgery
no symptoms- no treatment

21

medical therapy options

progestins (COC, provera, mirena)
danazol and gestrinone
GnRH agonists +/- therapy

22

infertility

inability to conceive after 12 months of sex w/o contraception
age of woman major factor

23

principle causes of infertility

ovulation problems
sperm problem
tubal problem
cervical factor
endometriosis

24

how to test ovulation

BBT (P- raises temp .3-.5 C)
serum progesterone
LH surge in urine (false + occurs)
endometrial Bx

25

tests of tubal patency

hysterosalpingogram
laparoscopy with dye

26

testing of cervical factor

requires careful cycle timing
must be done when cervical mucous is recptive
day 12,13
sample of mucous 4-20 hours after sex
good back up for men who don't want to give a sperm sample

27

semen analysis

48-72hrs of abstinence
must collect whole semen sample
must be examined w/in 1-2 hrs
count >20million/ml
motility >50%
morphology >15% should be completely normal
if abnormal repeat