Menopause

Question 1

When is the avg age of menopause?

Answer 1

~51 years

Question 2

What is considered as being early menopause?

Answer 2

<45 y.o

Question 3

Premature menopause?

Answer 3

<40 y.o

Question 4

Age of late menopause?

Answer 4

> 54 y.o

Question 5

How many ova does one born with?

Answer 5

1 million!!

Question 6

Efx of estrogen?

Answer 6

• IIary sexual characteristics

- –hair/ body shape/ fat distribution/ bone GROWTH/ endometrium proliferation

Question 7

In what situations does FSH and LH raise?

Answer 7

1. prior to OVULATION
2. with STOPPING combined OCP or depoprovera
3. Raised with breastfeeding or SSRI use

Question 8

Does a single raised level of FSH and LH suggest menopause?

Answer 8

NO

Question 9

How is FSH and LH released usually?

Answer 9

• pulsatile fashion

Question 10

What are the physical symptoms of menopause?

Answer 10

Hot flushes
Night sweats
Palpitations
Insomnia
Joint aches
Headaches

Question 11

How long do hot flushes last?

Answer 11

• 3-5mins

- ~2 years (10% for 15 years!!)

Question 12

Psychological problems with menopause?

Answer 12

• mood swings/ irritable/ anxiety/ forgertfulness

Question 13

What sexual changes occurs with menopause?

Answer 13

• vaginal DRYNESS

- libido

Question 14

What other symptoms may arise in menopause?

Answer 14

• UTIs/ dysuria/incontinence/freq.
• dry hair and skin
• atrophy of breast and genitals

Question 15

What bleeding disorders occur with menopause?

Answer 15

• irregular periods
• intra-menstrual bleeding
• post-menopausal bleeding

Question 16

How to manage menorrhagia?

Answer 16

• mefenamic acid
• tranexamic acid
• progesterones
• Intra-uterine sys
• endometrial ABLATION
• hysterectomy

Question 17

How are the short-term symptoms managed according to the NICE guidelines?

Answer 17

• consider HRT to alleviate mood:
  1. estrogen and progesterone pills (those with UTERUS)
  2. estrogen only pills (those w.o uterus)
• do NOT routinely offer SSRIs to treat vasomotor symptoms
• testosterone supplements for those with LOW sexual drive

Question 18

How to manage urogenital atrophy?

Answer 18

• vaginal estrogen

Question 19

When is HRT contraindicated?

Answer 19

• breast cancer
• undx abnormal vaginal bleeding
• endometrial cancer
• pregnancy
• thrombo-emoblic d.o
• recent MI
• liver disease with abnormal LFT
• porphyria cutanea tarda