PCOS and Menopause Flashcards Preview

Endocrine > PCOS and Menopause > Flashcards

Flashcards in PCOS and Menopause Deck (16):
1

typical PCOS presentations

chronic anovulation (oligo/amenorrhea, infertility)

hyperanrogenism (hirsutism, acne, alopecia)

2

clinical effects of treating PCOS with OCPs

suppress ovarian androgen secretion via suppression of gonadotropins

increases SHBG

decreases free T from free androgen index

improves hirsutism

regulates menses, provides progesterone to protect endometrial lining

2

clinical impact CEE with Bazedoxifene

releases VMS and vaginal atrophy

blocks bone resoption

BAZ proides endometrial protection and an alternative to progesterone for pt adverse to bleeding, breast tenderness, altered mood

3

non-hormone alternatives for vasomotor symptoms of menopause

SNRI/SSRI - paroxetine, venlafaxine

gabapentin

clonidine

4

indications for menopausal hormone therapy

symptomatic post menopausal women

progestin or SERM (bazedoxifene) must be prescribed with systemic ET for uterine protection in women with uterus


NOT indicated for prevention of chronic disease

5

contradictions for MHT

unexplained vaginal bleeding

Stroke

TIA / MI

breast+endometrial cancer

Pulmonay emboli VTE

Acute liver disease

6

premature menopause cut-off

6

Ospemifene =

SERM taking orally for atrophic vaginitis and dyspareunia

8

clinical impact of treating PCOS with spironolactone

improve androgenic symptoms

does not inhbit androgen secretion 

Pt still requires reliable contraception

10

typical onset time for hypergonadism symptoms in PCOS

peripubertal

11

consequences of estrogen deficiency in post menopausal years

increased risk of osteoporosis

increased risk of diabetes

increased risk of CHD and CVD

Changes in body composition (decreased lean mass)

skin changes

12

similarities of PCOS and metabolic syndrome related to insulin resistance

Central obesity

hyperinsulinemia

low SHBG

elevated TG, low HDL

Increased non alcoholic steatohepatitis

13

dx criteria for PCOS (rotterdam consensus)

2 of 3:
Oligo or anovulation

clinical/biochemical signs of hyperandrgogenism

polycystic ovaries on imaging

AND
absence of 2ndry causes (CAH, androgen secreting tumor, Cushings)

14

most effective treatment for vasomotor symptoms

Estrogen

15

vasomotor symptoms most likely at (period) 

early post menopause

(also in latet transition phase)

16

endometrial hyperplasia in PCOS due to

increased Estrone levels due to increased androgen levels converted in adipose tissue)