Week 6- Menopause Flashcards
What is the average age of menopause?
51 years.
When is it called early menopause?
<45 years
When is it called premature menopause?
<40 years
When is it called late menopause?
>54 years.
Why do you not get a period in/after menopause?
Once the follicles have all run out there is nothing to produce oestrogen anymore, therefore you don’t get a period.
What effects does oestrogen have on the body?
Secondary sexual characteristics Hair distribution, body shape and fat distribution Effect on collagen Bone growth Proliferates endometrium
What are the symptoms of menopause?
Hot flushes Amenorrhoea (12 months of amenorrhoea is necessary for diagnosis) or irregular periods Mood swings Night sweats Palpitations Joint aches Insomnia
At what age can you be diagnosed with menopause on symptoms along?
at the age of 45.
How else can you diagnose menopause in women younger than 45?
FSH (not allowed to do this in women >45) two occasions where it is >30
Why does FSH increase in women with menopause?
The FSH tries to get the follicles to mature, however there aren’t any, so levels go up in an attempt to counteract this.
Does a normal FSH mean she is not going through menopause?
No, it doesn’t exclude this.
In what other situations will FSH be raised?
Raised prior to ovulation Raised when stopping combined oral contraceptive or depo. Raised with breastfeeding and certain meds (SSRIs)
How long will the hot flushes last?
2-3 years. They occur in 3-5 minute intervals.
How can you conservatively manage hot flushes?
Avoiding sudden temperature change Avoiding spicy foods Avoiding caffeine and alcohol Reduce stress
What psychological symptoms can you get in menopause? How can you treat these?
Mood swings Irritability Anxiety Difficulty concentrating Forgetfulness HRT is the best option to treat these. However CBT can be of some use.
What sexual symptoms can you get with menopause?
Vaginal dryness Loss of libido- ovaries start to produce some testosterone.
What later symptoms may someone suffering from menopause have?
Recurrent UTI’s Frequency Dysuria Incontinence Dry skin and hair Atrophy of breasts and genitals
Why do you get intermenstrual bleeding and post menopausal bleeding in menopause?
Sometimes the FSH manages to stimulate an egg to be released, but because its taken it so much effort to do it the period you get is very heavy.
When would you be concerned about post menopausal bleeding? In a 54 year old? In a 70 year old or in a 90 year old?
In a 54 year old women its likely to be the ovaries finally responding to the FSH build up. In a 70 year old its likely to be malignancy In a 90 year old their tissues are more prone to damage so you are less worried.
What conservative management can aid with menopause?
Weight loss Diet Exercise Lifestyle Caffeine
What pills can you take to help with menorrhagia?
Mirena coil is helpful Start with mefenamic acid or tranexamic acid. Could also give an NSAID- reduces blood supply to womb and helps with pain Or an anti-fibrinolytic- Stops your clots from breaking down so bleed less. Progesterones- stop the bleeding. Endometrial ablation if that doesn’t work. Then hysterectomy if that doesn’t work.
Is osteoporosis associated with menopause?
Yes- menopause accelerates bone loss.
What does hormone replacement therapy consist of?
Can be both oestrogen and progesterone or just oestrogen (in little number of cases).
When would you give just continuous oestrogen only HRT? What forms does it come in?
Women without a uterus (If you’ve had a hysterectomy) or a mirena coil (as this already releases progesterone). Can be oral or transdermal.
