The Menopause Flashcards
(20 cards)
Endocrinal changes of menopause
LH and FSH increase, and Oestrogen rapidly decreases
An elevation of serum FSH past what is indicative of menopause?
40IU/L
Pre mature ovarian deficiency is defined as?
Menopause that occurs before age 40
A BSO, is a surgery used when women have fibroids, endometriosis, so on, but what inherited malignancy is also an indication
High risks of BRCA1 or 2 Gene mutations
The severity of menopausal symptoms is related to a certain circulating level of Oestradiol, what is it
Oestradiol <60pmol/L
30% die from ischemic heart disease strokes, what does Oestrogen play in that?
Oestrogen has a protective effect on vessel walls, and ofc oestrogen is reduced after menopause
Osteoporosis is also common in menopause, why?
Oestrogen depletion
Prevention of osteoporosis?
Calcium 1-1.5mg a day
HRT when done with Oestrogen only, has big risks like what
Risk for endometrial hyperplasia or endometrial carcinoma
What is the common HRT course if started during perimenopause
Oestrogen daily and Progestogen for 10-14 days
HRT course if started >12 months after LMP?
Oestrogen and progestogen everyday, “Bleed free HRT”
A woman has irregular bleeds that aren’t HRT withdrawal, and US shows endometrium >4mm thick, what do we do?
An endometrial biopsy, because it being bigger than 4 means risk of endometrial adenocarcinoma
Tibolone is a weaker synthetic steroid than combined HRT, but it’s used for what?
When patient wants to improve her libido
Tibolone dosage?
2.5mg
What are Selective Oestrogen receptor modulators (SERMs)?
They mimic estrogen, and as such don’t have that risk of endometrial hyperplasia and stimulating breast cancer cells
Most common cause of post menopausal bleeding?
Vaginal or endometrial atrophy
What is the primary route of estrogen administration for women at high risk of VTE?
Transdermal
A 55-year-old postmenopausal woman complains of vaginal dryness and dyspareunia. Which treatment is most appropriate for her symptoms?
A) Systemic estrogen-progestin therapy
B) Vaginal estrogen cream
C) Oral bisphosphonates
D) Selective serotonin reuptake inhibitors (SSRIs)
B
Which of the following is a long-term complication of estrogen deficiency?
a) Hot flashes
b) Osteoporosis
c) Vaginal dryness
d) Mood swings
Osteoporosis
Which HRT regimen is suitable for a woman >12 months post-menopause who desires no bleeding?
a) Cyclical sequential HRT
b) Continuous combined HRT
c) Estrogen-only HRT
d) Tibolone
Continuous combined HRT
