Menopause and Osteoporosis Flashcards
(62 cards)
typical age for menopause
45-55 years
Age for early menopause
40-45 years
If your patient is going through menopause and they are under 40 you should work them up for
ovarian disorder → primary ovarian insufficiency
what causes surgical menopause?
removal of ovaries surgically
How long must a woman have amenorrhea to be considered menopausal?
1 year
what will lab values be for a patient in menopause?
elevated FSH and low estradiol
consider TSH, HCG, prolactin
period where you transition from reproductive to non-reproductive years
perimenopause
what is the average duration of perimenopause? How many years before menopause does it occur?
4 years
5-10 years prior
How will cycle change in the perimenopause phase?
cycle may be shorter → shortened follicular phase
cycle may be longer → anovulation
What is the difference between perimenopause and menopause?
perimenopause is irregular menses and menopause is absence of menses
80% of women experience ___ with menopause
vasomotor symptoms
Symptoms associated with menopause
mood disturbances (anxiety, depression, irritable), sleep disturbance, poor concentration, heart palpitations, decreased interest/painful sex, drying/atrophy of vagina, infertility, fatigue, headache, tension, feelings of inadequacy or nonfulfillment
Two biggest effects of menopause
increased risk of CVD and increased risk for osteoporosis
Other effects of menopause
stress incontinence, loss of skin reilience and pliability, dry hair or loss, dry mouth, lower voice, easily traumatized skin, weight gain (truncal), osteoporosis
What are the treatment goals of managing menopause?
relieve symptoms
in which patients is HRT appropriate in treating postmenopausal women?
< 60 years, < 10 years out from onset of menopause, moderate to severe symptoms
Treatment for women with intact uterus to prevent endometrial hyperplasia
estrogen + progesterone
What type of HRT is preferred in women with moderate risk of CVD (decreases risk of thromboembolism)?
transdermal
What HRT method is preferred in women with genitourinary symptoms?
intravaginal
why are bioidentical hormone therapy preparations not recommended?
higher rates of adverse effects and lack of long term safety data
Contraindications for HRT
unexplained vaginal bleeding, thrombophilia, breast or endometrial cancer, arterila thromboembolic disease (stroke, TIA, MI, PE, DVT), liver disease, anaphylactic reaction, pregnancy
Benefits of HRT in menopause
reduced risk for hip fracture
reduced risk of colorectal cancer
reduced breast cancer risk (estrogen only HRT)
alternative to estrogen replacement for women at risk for osteoporosis who cannot or prefer not to take estrogen
Selective Estroen Receptor Modulators (SERMs)
Nonhormonal therapies for menopause
SSRI, SNRI, gabapentin, pregabalin
