Menopause Lecture

Question 1

To define menopause, must have amenorrhea (without period) for….

Answer 1

1 year

Question 2

Average menopause age

Answer 2

51

Question 3

Permanent cessation of menstruation that occurs after the loss of ovarian activity

Answer 3

Menopause

Question 4

Menopause transition (formerly “perimenopause”) can last about…

Answer 4

4 years

Question 5

• Estradiol and progesterone decrease
• Follicle-stimulating hormone (FSH) increase

occurs during..

Answer 5

menopause transition

Question 6

Are there any blood tests indicated to diagnose menopause?

Answer 6

NO

Question 7

“Day 1 of menstrual cycle” is…

Answer 7

first day of your period

Question 8

When giving a menopausal women estrogen (and she has a uterus), what else MUST you give her to avoid giving her endometrial cancer

Answer 8

Progesterone

Question 9

During menopause, are you producing estrogen and progesterone?

Answer 9

NO

Question 10

Menopause symptoms can begin how many years before periods stop?

Answer 10

1-3 years

Question 11

Vasomotor (hot flashes)
Vaginal symptoms (inelastic, dry)
Sleep disturbances
New-onset depression

Answer 11

Menopausal symptoms

Question 12

• “sudden sensation of extreme heat in the upper body, particularly the face, neck and chest”
• episodic, typically last 1-5 minutes
• characterized by perspiration, flushing, chills, clamminess, anxiety and occasionally heart palpitations
• may interfere with sleep
• affects ~75% women

Answer 12

Vasomotor symptoms

Question 13

• vary in frequency and duration
• 87% of women who report hot flashes experience these symptoms on daily basis, with 33% experiencing more than 10 hot flashes per day

*duration: ~6 months to 2 years although wide variation in duration and still unclear

Answer 13

Hot flashes

Question 14

• fluctuations in reproductive hormones appear to play critical role
• thermoregulatory zone narrowed
• genetic predisposition
• ethnic and racial differences (i.e., differing perceptions, physiology and/or diets high in soy products)
• obesity

Answer 14

can all impact hot flashes

Question 15

Vaginal atrophy is a direct consequence of a ____estrogenic state

Answer 15

HYPO (lower estrogen)

Question 16

vaginal or vulvar dryness
discharge
itching
dyspareunia

Answer 16

vaginal symptoms of menopause

Question 17

• loss of superficial epithelial cells in GU tract  thinning of tissue
• loss of vaginal rugae and elasticity  narrowing and shortening of vagina
• loss of subcutaneous fat in labia majora  narrowing of introitus, fusion of labia minora and shrinking of clitoral prepuce and urethra

Answer 17

seen in menopause

Question 18

vaginal pH more alkaline  alter vaginal flora and increase risk of urogenital infx
vaginal secretions may decrease

Answer 18

see in menopause

Question 19

color of vulva in post menopausal women

Answer 19

more pale

Question 20

when can you give estrogen alone as treatment for menopause?

Answer 20

no uterus (hysterectomy)

Question 21

does progesterone help with menopause symptoms?

Answer 21

NO! but you MUST give if a pt has a uterus in order to prevent endometrial cancer

Question 22

this form of estrogen has a slightly decreased risk of DVT/clotting

Answer 22

estrogen patch

good to try the patch first bc of this

Question 23

estrogen treatment can reduce hot flashes by…..

Answer 23

75%

Question 24

SSRI
SNRI
Clonidine
Gabapentin
Progestin-only (not common)

Answer 24

alternative treatments of vasomotor symptoms (instead of estrogen)