Menopause: What's the big deal

Question 1

Menopause?

Answer 1

One year without menses

Question 2

Perimenopause?

Answer 2

Age group near menopausal age, 45-55. With symptoms - menopausal transition

Question 3

Postmenopause?

Answer 3

Beyond menopause or age > 55

Question 4

Does the ovary continue to produce eggs after age 43?

Answer 4

Yes –> sporadically, they are abnormal

Question 5

How much estrogen is being produced in perimenopausal women?

Answer 5

Low amounts

Question 6

What rises because of the low amount of estrogen produced?

Answer 6

FSH

Question 7

Menses become what in perimenopause?

Answer 7

Less frequent, lighter

Question 8

Most common symptom of menopause?

Answer 8

Hot flashes

Question 9

What causes hot flashes?

Answer 9

Gonadotropin spike as well as estrogen deficiency

Question 10

When can hot flashes begin?

Answer 10

During perimenopause

Question 11

What else can hot flashes cause?

Answer 11

Vasodilation and skin changes

Question 12

During menopause what can occur at night?

Answer 12

Wake up with sweats followed by a cooling effect

Question 13

Night sweats during menopause can occur how many times per night?

Answer 13

Up to 5

Question 14

What will happen to the night sweats with no treatment?

Answer 14

Will dissipate

Question 15

When do you give estrogen for hormone replacement therapy?

Answer 15

If there are moderate-to-severe vasomotor symptoms associated with menopause

Question 16

Why do add a progesterone replacement drug in some women?

Answer 16

If they still have a uterus to prevent endometrial cancer

Question 17

What is the preferred treatment for pts with only vaginal symptoms (dryness or dyspareunia)?

Answer 17

Vaginal Estrogens

- No progestins needed

Question 18

Do women who had a hysterectomy need to take progesterone replacement?

Answer 18

Nope

Question 19

Other symptoms of menopause?

Answer 19

Vaginal atrophy –> late effect

Question 20

How do you treat vaginal atrophy?

Answer 20

Estrogens - either vaginally or systemically

Question 21

Medical illnesses associated with menopause?

Answer 21

Osteoporosis
Cancer
Heart disease

Question 22

High risk grps for osteoporosis?

Answer 22

White/Asian
Thin
Smoker
Alcohol use
Steroid use
FHx

Question 23

The number one killer of older women?

Answer 23

CVD

Question 24

What is early loss of endogenous estrogen associated with?

Answer 24

CVD

Question 25

What does endogenous estrogen do for the CV system?

Answer 25

Increases smooth muscle proliferation, lowers cholesterol, increases vascular tone

Question 26

What does a women's CV system look like at age 35?

Answer 26

Fatty streaks and minimal athersclerotic plaque

Question 27

What happens at age 45?

Answer 27

Lesions begin to progress (Perimenopause)

Question 28

What happens 5-8 years after menopause?

Answer 28

Increase in plaques and intima-media thickening

Question 29

When does women's CV risk equal men's?

Answer 29

after 65

Question 30

Do you give estrogen to treat secondary CVD in females?

Answer 30

No --> increases risk for heart attack

Question 31

What is the use of HT in perimenopause?

Answer 31

Positive effects on vascular remodeling of age Decreases intimal thickening Decreases the incidence of plaques

Question 32

How long must you be on EPT before an increase in risk of breast cancer occurs?

Answer 32

5 years