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44 Cards in this Set
- Front
- Back
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when does menopause occur?
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12 months after last menses
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what is menopause accompanied by?
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physiologic and emotional changes
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what is premature menopause/ovarian failure?
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menopause prior to 40 when follicles have stopped producing
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what does menopause increase risk for?
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CV disease
osteoporosis |
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what are the 3 stages of menopause?
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initial shortening then lengthening of cycles
irregular and skipped cycles eventual demonstration of amenorrhea |
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what 3 hormone changes occur with menopause?
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negative HCG
increasing FSH low estriol |
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what 2 hormones begin to decline by age 30?
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progesterone
estrogen |
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what happens to ovaries with increasing age and what is it likely due to?
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ovaries become unresponsive to gonadotropins likely due to a decreasing number of primordial follicles
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what are 3 components of the physiology of menopause?
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decrease in overall production of inhibin B
progesterone and 17-beta estradiol production stops estrogen formed in small amounts in peripheral tissues |
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what is inhibin B?
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regulates the release of FSH
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how does inhibin B increase FSH with menopause?
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inhibin B decreases so there is nothing to regulate FSH production
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what is the definitive establishment of menopause?
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when there is a depletion of ovarian follicles and failure to respond to pituitary gonadotropins
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what are 5 things that may cause premature menopause?
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AI disorders
radiation oopherectomy chemo GnRH analogs |
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what are 4 major symptoms of menopausal transition?
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vaginal symptoms
vasomotor symptoms insomnia memory loss and fatigue |
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what are vaginal changes due to in menopause?
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estrogen levels
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what are 2 main ways to treat vaginal symptoms?
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OTC lubricants
estrogen preparations |
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how do estrogen preparations work? (3)
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change cytology, pH, and symptoms
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what hormone decreases the most in menopause?
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estrogen
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what hormone decreases by 70% in menopause?
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progesterone
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what 2 hormones increase in menopause?
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FSH and LH
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What major hormone group also decreases significantly with age?
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androgens
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what are 5 differential diagnoses for menopause?
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alcohol consumption
carcinoid dumping syndrome hyperthyroidism opiate withdrawal |
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what is the postulated theory behind vasomotor symptoms of menopause?
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central thermoregulatory mechanisms are altered at menopause and lower the threshold for heat loss
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what are 2 lifestyle changes involving weight that can help menopause symptoms?
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high-fiber, low fat diet
exercise |
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what supplement may help menopause symptoms?
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calcium
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what are 5 general lifestyle changes that can help menopause symptoms?
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don't smoke
minimize alcohol regular sexual activity daily sunlight relaxation |
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why is exercise good in menopause? (4)
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moderated CAD risk
reduces BMI mitigates bone loss endorphin release |
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what are 2 herbal treatments for hot flashes?
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soy
black cohosh |
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what is a side effect of black cohosh?
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anticoagulant
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what must always be evaluated in menopause?
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post-menopausal bleeding
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what is contraindicated in women with intact uterus?
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unopposed estrogen
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what are 2 benefits of hormone replacement therapy?
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improves bone density
decreases colon cancer risk |
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what does hormone replacement therapy increase the risk for? (5)
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breast cancer
DVT CV disease stroke cognitive changes |
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what are combines hormone therapy treatmnts?
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regimens that include cyclic addition of progesterone to estrogen regimens or may be continuous
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what 3 things will combined HRT affect?
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lipid profiles
glucose tolderance insulin insensitvity |
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what effect with progesterone have on HDL and vascular tone?
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opposite of estrogen
(i.e. decreases) |
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what are 6 contraindications of HRT?
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thromboembolic history
liver disease pregnancy breast or uterine cancer unexplained vaginal bleeding recent or active endometriosis |
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what are 4 things you should use caution with when administering HRT?
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high CV risk
gallbladder disease estrogen only in pts with a uterus fibroids |
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what are SERMs?
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selective estrogen receptor modulators that block the effects of estrogen in the breast tissue
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what can SERMs cause? (5)
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fatigue
hot flashes night sweats vaginal discharge mood swings |
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why do SERMs have varried effects?
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because estrogen receptors vary slightly across estrogen-responsive tissues so SERMs might have agonist or antagonist effects
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who may androgens benefit?
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women with low libido
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what are 4 risks for androgens?
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worsening lipid and CV profiles
acne clitoromegaly voice changes |
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what are 5 things that are affected by both menopause and HRT?
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fracture risk
CV disease stroke cancer cognition |
