Menopause and Secondary Amenorrhoea Flashcards

1
Q

What is the definition of menopause?

A

Last lifetime period

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2
Q

What is the average age for menopause?

A

51

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3
Q

What is the cause of menopause?

A

Ovarian failure - estradiol falls, FSH rises

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4
Q

What are the symptoms of menopause?

A
Vasomotor symptoms (hot flush) 
Vaginal dryness/soreness 
Low libido 
Muscle and joint aches 
Mood changes 
Poor memory
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5
Q

What is the ‘silent risk’ of menopause?

A

Reduced bone mass, could lead to osteoporosis

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6
Q

What are the risks associated with osteoporosis?

A
Thin 
Caucasian 
Smoking 
Amenorrhoea 
Steroid use 
Malabsorption 
Hyperthyroidism 
EtOH
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7
Q

What is the prevention and treatments for osteoporosis?

A

Weight bearing exercises
Adequate calcium and vitamin D
HRT
Bisphosphonates

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8
Q

What are the symptom treatments for menopause?

A

Hormone replacement therapy
Selective oestrogen receptor modulators
Antidepressants
Non hormonal lubricants

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9
Q

What are the different types of HRT?

A

Local vaginal pessary/ring/cream

Systemic transdermal/oral

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10
Q

What are the benefits of HRT?

A

Vasomotor
Local genital symptoms
Osteoporosis
Colon cancer

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11
Q

What are the risks of HRT?

A

Breast cancer
Ovarian cancer
Venous thrombosis

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12
Q

What is andropause?

A

Testosterone falls by 1% a year after 30

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13
Q

What is primary amenorrhoea?

A

Never had a period

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14
Q

What is secondary amenorrhoea?

A

Has had periods in past but none for 6 months

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15
Q

What are the causes of secondary amenorrhoea?

A
Pregnancy /breastfeeding 
Contraception 
Polycystic ovaries 
Early menopause 
Thyroid disease/Cushings 
Raised prolactin 
Hypothalamic (stress, weight change, exercise) 
Androgen secreting tumour 
Sheehans syndrome 
Ashermans syndrome
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16
Q

What investigations would you use for secondary amenorrhoea?

A

Urine pregnancy test and dipstick for glucose
Bloods (FSH, LH)
Pelvic USS

17
Q

What would you look for in an examination for secondary amenorrhoea?

A
BP 
BMI 
Acne 
Hirsutism 
Enlarged clitoris/ deep voice
18
Q

How to polycystic ovaries present?

A

Oligo/amenorrhoea
Androgenic symptoms (hair, acne)
Anovulatory infertility
First trimester miscarriage

19
Q

What are polycystic ovaries associated with?

A

Diabetes

Cardiovascular disease

20
Q

How are polycystic ovaries managed?

A

Weight loss/exercise
Antiandrogen (combined hormonal contraceptive)
Endometrial protection