Physio of Menopause Flashcards
(30 cards)
What are the 3 types of estrogen?
- estrone (E1)
- etradiole (E2)
- estriole (E3)
When is estrone (E1) the lowest?
estrone is lowest in non-pregnant women of child bearing age. It becomes even lower in menopause when the ovary secretion of estrone decreases (fat pad and adrenal synthesis increases but still have overall estrone decline)
When is estradiole (E2) concentrations the highest? What happens during menopause?
- highest in non-pregnant women of child bearing age. (only made in the ovaries and the fat pads)
- during menopause these levels drop drastically
What synthesizes estriole (E3)?
placenta during pregnancy
When does atresia start to accelerate and what is the result?
atresia accelerates around age 37 and results in irregular menses
What is the most commonly resorted symptom of the onset of menopause?
menstrual cycle irregularity
What is the basic cause of irregularity of timing in the LH surge?
- reduction of E2 which therefore exerts less negative feedback on the amygdala of the hypothalamus and results in increased Kisspeptin-10 secretion which stimulates hypothalamus to secrete more GnRH.
- decreased inhibitory input on GnRH secreting nerves from GABA and norepinephrine secreting nerves
* *these two events shift balance toward the stimulatory side for GnRH and FSH/LH
What happens to PRL, TSH, and cortisol levels post menopause
remain similar to those of pre-menopause
What are the levels of progesterone, E2, LH and FSH post menopause?
Progesterone (near zero) and E2 are low while FSH and LH are high
How does the ratio of E2:E1 change from pre- to post menopause?
pre=high ratio
post=low ratio (E1 continuous to be made in the fat tissue and the adrenal and liver)
What happens to testosterone, androgens, GH and DHEA in post menopause?
decline
What happens to PRL, TSH, and cortisol levels post menopause
remain similar to those of pre-menopause
Why do some people get hot flashes and others don’t?
lessend E2 causes a narrowing of the thermoneutral zone. Depending on the intensity of the narrowing, some people do and some don’t get hot flashes.
What triggers hot flashes?
A pulse in LH, serotonin or dopamine, or may be thought to be set by neural signals from the medulla
What is the second most common symptom of perimenopause and describe it?
Hot flashes that can last for a few minutes and usually occur in the middle to later stages of perimenopause. Skin temp can increase from 1-7 degrees and a chill often follows
Among which demographic are hot flashes more common?
African American > caucasion > chinese
What results from low levels of gonadotropins (estrogen and progesterone) in menopausal and post menopausal stages?
- osteoporosis
- muscle wasting
- increased cardiovascular pathologies
- loss of bilateral mastalgia
what drugs can contribute to hot flashes?
- tamoxifen
2. raloxifene
What diseases can lowered estrogen in the peri and post menopausal state lead to?
- lowered blood flow and tendency toward vascular hypertension
- Higher LDL and lower HDL leading to increased risk of atherosclerosis and coronary artery disease
What are the 2 types or estrogen receptors and where are they located?
ER alpha and ER beta in the cerebral cortex
What are the 2 types or estrogen receptors and where are they located?
ER alpha and ER beta in the cerebral cortex
What symptoms of menopause can estrogen therapy treat?
night sweats and sleeping problems (increases REM sleep)
What is EPT?
estrogen-progestin therapy that can be used at bedtime to improve sleep
What sexual functioning effects occur during perimenopause?
decreased sexual responsively, sexual frequency and libido.
Increased vaginal dyspareunia and partner problems
