The Menopause Flashcards
(19 cards)
What is the definition of the menopause?
Permanent cessation of menstruation due to loss of ovarian follicular activity, 12 months since final menstrual period.
Median age= 51 years old
What is perimenopause?
Period of time from the beginning on menopausal symptoms to 12 months after last menstrual period. Usually starts in 40s.
Give 3 symptoms of perimenopause
Weight gain in lower abdomen, buttocks and thighs
Varying menstrual cycle length
Hot flushes + night sweats
Describe the physiological changes that occur in the menopause
Abscense of follicular development Extreme reduction in oestrogen levels --> ovary stops producing oestrogen FSH= increased by 10-20 fold LH= increases by 3 fold Androgens= increases
Give 5 symptoms of the menopause
Depression Headaches Fatigue Hot flushes Loss of libido Increased cardiovascular risk Osteoporosis- bony fractures Genital and urinary tract atrophy- dyspareunia, itching, burning, dryness
What is the definition of early menopause?
Menopause before the age of 40. Affects 1% of women
Give 3 causes of early menopause
Premature ovarian failure (Turner’s, autoimmune, TB, malaria)
Radio/chemotherapy
Surgical- bilateral oophorectomy
Give 3 benefits of HRT medication
Cures hot flushes
Increases libido
Decreases risk of osteoporotic fractures
Decreases risk of colorectal cancers
Give 3 risks of HRT medication
Increases risk of breast cancer
Increased risk of endometrial cancer
Increased risk of VTE
Increased risk of gallbladder disease
Give 4 side effects of HRT
Nausea Headaches Breast tenderness Indigestion Abdominal pain Vaginal bleeding
Give 4 contraindications for starting HRT
Hx of breast, ovarian or endometrial cancer Hx of thromboembolism Hypertension Liver disease Pregnant
What type of HRT should be given to women post-hysterectomy?
Oestrogen only HRT
What type of HRT should be given to women with a uterus?
Combined oestrogen and progesterone
Progesterone protects against uterine cancers
What type of HRT should be given to women with vaginal atrophy?
Topical oestrogens
Give 4 potential alternatives to HRT
Lifestyle changes (exercise regularly, eat healthily, stop smoking, cut down on coffee and alcohol)
Clonidine (alpha-adrenoreceptor agonist)
Tibolone (synthetic HRT)
Herbal remedies
Prevention of osteoporosis (Ca2+, vitamin D, bisphosphonates)
What is the definition of postmenopausal bleeding?
Vaginal bleeding over 12 months after last menstrual bleed
Give 5 causes of postmenopausal bleeding
Endometrial cancers Cervical cancers Endometrial hyperplasia Atrophic vaginitis Cervicitis Cervical polpys
How is postmenopausal bleeding investigated?
Bimanual and speculum examination
Cervical smear
Transvaginal USS
Endometrial biopsy and hysteroscopy
How is postmenopausal bleeding managed?
Treat obvious cause
Rule out malignancy
If atrophic vaginitis- topical oestrogens
