Post-menopausal health

Question 1

Who is menopause?

Answer 1

Your last menstural period (the point where you stop releasing eggs)

Question 2

If you have a hysterectomy you go through menopause earlier TRUE/FALSE

Answer 2

TRUE (3-4 years earlier)

Question 3

What is the average age of menopause?

Answer 3

51

Premature if <40y, Early if <45y, late if >54

Question 4

Woman are cardio protected before menopause, after menopause it is the same risk as men true/false

Answer 4

true

Question 5

TRUE/FALSE

FSH & LH are raised with breastfeeding

Answer 5

TRUE

Question 6

What are vasomotor symptoms caused by?

Answer 6

Constriction and dilation of blood vessels

Question 7

How long on average do hot flushes last for?

Answer 7

2 years (last 3-5 minutes)

Question 8

Treatment for menopause

Answer 8

Conservative- Diet, Wt loss, Excersie, Lifestyle, Caffeine
HRT- Oestrogen alone, Oestrogen and progesterone
Non-HRT- Clonidine, SSRIs

Question 9

What is a common side effect of HRT within the first 3 months of treatment?

Answer 9

Unscheduled vaginal bleeding

Question 10

What are the benefits of HRT?

Answer 10

Symptomatic relief, psychological
Aches and pains, urogenital system
ALSO Osteoporosis, colorectal cancer, CHD

Question 11

Risks of HRT

Answer 11

VTE (only if oral)
CVA (no increased risk if start before 60)
Breast Cancer (if Oestrogen+Progesterone)
Gallbladder disease

Question 12

What can be used to relieve the symptoms of vaginal atrophy?

Answer 12

Vaginal oestrogen

Question 13

What is needed to diagnose menopause?

Answer 13

WOMEN WHO HAVE NOT HAD A PERIOD FOR AT LEAST 12M AND ARE NOT USING HORMONAL CONTRACEPTION

Question 14

What is perimenopause diagnosed on the basis of?

Answer 14

Vasomotor symptoms (hot flushes and night sweats) and irregular periods

Question 15

What is urinary incontinence?

Answer 15

The complaint of involuntary leakage of urine

Question 16

With stress incontinence what is the most important lifestyle thing to reduce?

Answer 16

Smoking

Question 17

With OAB what are the most important lifestyle changes?

Answer 17

Reduce alcohol and caffeine

Question 18

Limiting fluid intake makes incontinence better TRUE/FALSE

Answer 18

FALSE

It worsens incontinence as it reduced your bladder capacity

Question 19

Mirabegron is used for which type of incontinence?

Answer 19

OAB (as it increased relaxation)

Question 20

Name an antimuscarinic agent?

Answer 20

Oxybutynin (inhibits involuntary contractions)

Question 21

When would you add desmopressin in as a treatment for incontinence?

Answer 21

If there was nocturia

Question 22

How does duloxetine increase sphincter muscle activity?

Answer 22

by serotonin reuptake inhibition and stimulation of a-adrenoreceptors

Question 23

Prolapse happens in what percentage of parous women?

Answer 23

50%

Question 24

What is an anterior prolapse called?

Answer 24

Cystocele

Question 25

What is a middle compartment prolapse called?

Answer 25

Enterocele

Question 26

What is a posterior compartment prolapse called?

Answer 26

Reterocele

Question 27

What is a good pessary as an initial trial?

Answer 27

Ring pessary

Question 28

What are the pelvic floor muscles?

Answer 28

A group of muscles that attach to the pubic bone at the front of the pelvis, go to base of the spine at the back

Question 29

What may cause the Pelvic floor muscles to become weak>

Answer 29

``` Childbirth Overweight Constipation/straining to empty bowels Heavy lifting Chronic cough Menopausal change ```