what is average age of menopause?
51
how make diagnosis of menopause?
it’s when been no periods for 12 months + symptoms (clinical diagnosis)
when is post menopause?
time period after 12 months since menstruation stopped
what is perimenopause?
includes time leading up to menopause all the way to 12 months since menstruation stopped
what physiology causes menopause?
*normally follicles develop all the time, stimulated by FSH the follicles grow granulosa cells producing oestrogen
in menopause = decline in development of oestrogen follicles so get decreased oestrogen (& increased LH + FSH since they’re trying to stimulate)
what are some perimenopausal symptoms?
- hot flushes
- emotional lability/low mood
- premenstrual symptoms
- joint pains
- vaginal dryness & atrophy
- irregular periods
- light/heavy periods
- reduced libido
what are some risks of low oestrogen?
- CV disease & stroke
- osteoporosis
- pelvic organ prolapse
- urinary incontinence
what are some different treatment options for perimenopausal symptoms?
- HRT
- tibolone (synthetic steroid hormone, continuous combined HRT only used post menopausal)
- clonidine (non hormonal management)
- CBT
- SSRIs
- testosterone (for reduced libido)
- vaginal oestrogen (helps dryness/atrophy)
- vaginal moisturisers
when need contraception in menopause?
should be on until 2 yrs after last menstruation if <50 yrs or 1 yr after last menstruation if > 50 yrs
what HRT can be used in women with no uterus?
oestrogen only HRT
what HRT can be used in women still with periods & uterus?
cyclical HRT & cyclical progesterone (with regular breakthrough bleeds)
what HRT can be used in postmenopausal women with uterus?
continuous combined HRT (like tibolone)
what are risks of HRT?
- increased risk breast cancer
- increased risk endometrial cancer (why add progesterone if still have uterus)
- increased risk VTE
- increased risk stroke
what is premature ovarian insufficiency?
menopause <40yrs
- test & find high LH+FSH and low oestrogen
what are treatments of premature ovarian insufficiency?
- HRT
- COCP (often feel less stigma & can be used contraception)
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1- ovarian cancer pathology15
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1 - cervix & vagina pathology9
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1 - adolescent gynae17
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1 - uterine fibroids5
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1 - termination of pregnancy12
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1 - early pregnancy complications18
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1 - infertility & assisted conception20
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1 - acute gynaecology6
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1 - formative quiz25
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1 - menstrual disorders21
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1 - histology female reproductive anatomy17
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2 - nutrition in pregnancy11
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2 - genetics pregnancy6
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2 - preterm labour19
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2 - hypertension in pregnancy18
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2 - prescribing in pregnancy8
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2 - small for gestational age11
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2 - large for gestational age8
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2 - physiology pregnacy15
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2 - antenatal care10
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3 - normal labour18
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3 - maternal infections11
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3 - maternal sepsis9
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3 - haemorrhage24
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3 - miscarriage19
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3 - adaptation at birth7
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4 - postpartum2
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4 - prolapse7
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4 - complicated labour9
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5 - contraception27
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5 - sexual health6
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5 - infections38
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5 - menopause15
