Menopause Pathophysiology

Question 1

How is menopause identified?
Average age, range?
Depends on?

Answer 1

• RETROSPECTIVELY 1 year after the last period
• 40-58 Avg 51
• Depends on genes

Question 2

If you get your uterus removed are you in menopause?

Answer 2

No, your hormones are still being produced

Question 3

When does menopause happen early?

Answer 3

• Women who smoke
• Sometimes after chemo
• Sometimes after radiotherapy
• After a bilateral oophorectomy (removing eggs)

Question 4

When do women have the highest number of follicles

Answer 4

20 week gestation

Question 5

Where is estrogen produced in the menstrual cycle? Which type

Answer 5

Ovaries produce estrogen
- estradiol (most potent)

Question 6

In Perimenopuase, where is estrogen produced? which type?

Answer 6

Less estrogen produced by ovaries
- Androstenedione (from adipose) produces estrone

Question 7

In Perimenopuase, where is estrogen produced? which type?

Answer 7

All estrogen produced from Androstenedione
- estrone

Question 8

How do you know if lack of period is due to hysterectomy or menopause

Answer 8

Check FSH, LH, estradiol levels
- Lack of period + high FSH/LH is likely menopause

Question 9

When do vasomotor symptoms happen? how long does it last?
What are the symptoms

Answer 9

Happens 2 years before menopause
- can last 7-8 years

Hot flashes
Night sweats
Anxiety

Question 10

What are other symptoms of menopause?

Answer 10

• Aches/pain common during transition
• Mood (irritability, anxiety, low energy)

Question 11

When does genitourinary syndrome happen?
What are they?

Answer 11

Happens 5-6 years after menopause

Vaginal dryness, itchiness
Lower libido
Urinary incontinence
Vulvovaginal atrophy
- vagina can shorten, constrict, lose elasticity, decrease sebaceous gland secretions