PostMenopausal

Question 1

• OV become unresponsive to gonadotropins & stop producing progesterone, estrogen & estradiol therefore OV ↓ in size & follicles disappear
• Menses become irregular 45- 55 yrs
• UT & endo become ATROPHIC
• Post menopausal bleeding may occur due to atrophic endo

Answer 1

Postmenopausal sono

Question 2

• UT & CX contours maintained
• Sm. amt of fluid in CX due to CX stenosis
• ↓ estrogen levels = THINNER stripe
• Endo appears as stripe < 8 mm (asymptomatic pt.)
• 4-5 mm upper limits of NORMAL if history of bleeding
• Pt. w/ UNOPPOSED ESTROGEN hormone replacement < 8 mm
• Pt. w/ sequential hormone replacements, endo up to 10-12 mm
• Myometrium may have calcified ARCUATE arteries

Answer 2

Normal anatomy

Question 3

• Relieves symptoms of menopause & prevents osteoporosis

* Unopposed Estrogen assoc w/ ↑ risk of endo Ca & hyperplasia

Answer 3

Hormone replacement therapy

Question 4

any bleeding (in an older woman), 6 months after last menstrual period
• ENDOMETRIAL ATROPHY- m/c cause WITHOUT HRT on TEST
• M/C cause Exogenous estrogen administration
• Endo CA
• Cervical CA
• Estrogen producing functional OV tumor (rare)

Answer 4

postmenopausal bleeding

Question 5

– non steroidal antiestrogen used as a chemotherapeutic agent in pt. w/ breast CA
• Causes changes in endo w/ ↑ risk for endo CA

Answer 5

Tamoxifen