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33 Cards in this Set
- Front
- Back
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FSH is generally found to be >30 mIU/mL
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actual menopause levels
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actual menopause levels of FSH
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FSH is generally found to be >30 mIU/mL
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The age of menopause is not influenced by the age of menarche, number of ovulations or pregnancies, lactation, or the use of oral contraceptives.
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The age of menopause is not influenced by the age of menarche, number of ovulations or pregnancies, lactation, or the use of oral contraceptives.
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premature ovarian failure.
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menopause before the age of 40
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premature ovarian failure.
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menopause before the age of 40
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the major product of the postmenopausal ovary
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Contrary to popular belief, the ovaries of postmenopausal women are not quiescent. Under the stimulation of LH, theca cell islands in the ovarian stroma produce hormones, primarily the androgens testosterone and androstenedione. Testosterone appears to be the major product of the postmenopausal ovary. Testosterone concentrations decline after menopause, but remain two times higher in menopausal women with intact ovaries than in those whose ovaries have been removed
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the predominant endogenous estrogen in postmenopausal women
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Estrone Androstenedione is converted to estrone in fatty tissue
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Relative Changes in Follicle-stimulating Hormone (FSH) as a Function of Life Stages
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Childhood
<4 Prime reproductive years 6-10 Perimenopause 14-24 Menopause >30 |
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Relative Changes in Follicle-stimulating Hormone (FSH) as a Function of Life Stages
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Childhood
<4 Prime reproductive years 6-10 Perimenopause 14-24 Menopause >30 |
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the first physical manifestation of decreasing ovarian function and is a symptom of vasomotor instability.
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the hot flush
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the first physical manifestation of decreasing ovarian function and is a symptom of vasomotor instability.
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the hot flush
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When perimenopausal and postmenopausal women receive hormone therapy, hot flushes usually resolve in
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3 to 6 weeks
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When perimenopausal and postmenopausal women receive hormone therapy, hot flushes usually resolve in
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3 to 6 weeks
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If a menopausal woman does not receive hormone therapy, hot flushes usually resolve spontaneously within
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2 to 3 years, although some women experience them for 10 years or longer.
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If a menopausal woman does not receive hormone therapy, hot flushes usually resolve spontaneously within
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2 to 3 years, although some women experience them for 10 years or longer.
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more common in the hypoestrogenic patient
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uterine prolapse
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more common in the hypoestrogenic patient
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uterine prolapse
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Because of atrophy of the lining of the urinary tract in menopause, there may be symptoms of dysuria and urinary frequency, a condition called
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atrophic
P.332 urethritis. Hormone therapy can relieve the symptoms of urgency, frequency, and dysuria. Loss of support to the urethrovesical junction may result in stress urinary incontinence; in some cases, hormone therapy plus pelvic muscle (Kegel) exercises may relieve some of these symptoms. |
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Estrogen stimulates the production of the sex hormone-binding globulin which....and therefore
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which binds androgens and estrogens. With declining estrogen production, less sex hormone-binding globulin is available, thus increasing the level of free testosterone. Increased testosterone levels may result in increased facial hair. Moreover, changes in estrogen production affect the rate of hair shedding. Hair from the scalp is normally lost and replaced in an asynchronous way. With changes in estrogen production, hair is shed and replaced in a synchronous way, resulting in the appearance of increased scalp hair loss. This is a self-limiting condition and requires no therapy, but patients do require reassurance. Nails become thin and brittle with estrogen deprivation, but are restored to normal with estrogen therapy.
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Estrogen affects the development of what type of bone
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cortical and trabecular bone, although the effect on the latter is more pronounced. Bone density diminishes at the rate of approximately 1 % to 2% per year in postmenopausal women, compared with approximately 0.5% per year in perimenopausal women
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mg of daily calcium intake for menopausal women is recommended
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1500 mg
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In addition, for those with limited sun exposure or those lacking other dietary sources, supplementation with vitamin D should be considered:
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10 µg from ages of 51 to 70; 15 µg, older than 71.
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Alkylating cancer chemotherapeutic agents affect the
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the membrane of ovarian follicles and hasten follicular atresia
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The changes of menopause result from
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declining 17-β estradiol production by the ovarian follicles
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When administered orally, 17-β estradiol is
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oxidized in the enterohepatic circulation to estrone. 17-β estradiol remains unaltered when it is administered transdermally, transbucally, transvaginally, intravenously, or intramuscularly. Unfortunately, intramuscular estradiol administration results in unpredictable fluctuations in plasma concentration. When estradiol is administered across the vaginal epithelium, absorption is poorly controlled, and pharmacologic plasma concentrations of estradiol can result. Transdermal administration of estradiol results in steady, sustained estrogen blood levels and may be a preferable alternative to oral dosing for many patients.
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The administration of continuous unopposed estrogens can result in endometrial hyperplasia and an increased risk of endometrial adenocarcinoma. Therefore,
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it is essential to administer a progestin in conjunction with estrogens in women who have not undergone hysterectomy
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The administration of continuous unopposed estrogens can result in endometrial hyperplasia and an increased risk of endometrial adenocarcinoma. Therefore, it is essential to administer a progestin in conjunction with estrogens in women who have not undergone hysterectomy. Progestins may include any variety of synthetics, such as
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medroxyprogesterone acetate and norethindrone or micronized progesterone. To achieve this protective effect, the progestin chosen may be given continuously in low doses or sequentially in higher doses. Sequential dosing is usually for 10 or 12 days each calendar month. Progestins may be associated with unacceptable side effects, such as affective symptoms and weight gain. If estrogen is administered alone because of unacceptable side effects of progestins, then it is imperative to counsel the patient about the need for yearly endometrial biopsy.
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The administration of continuous unopposed estrogens can result in endometrial hyperplasia and an increased risk of endometrial adenocarcinoma. Therefore, it is essential to administer a progestin in conjunction with estrogens in women who have not undergone hysterectomy. Progestins may include any variety of synthetics, such as
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medroxyprogesterone acetate and norethindrone or micronized progesterone. To achieve this protective effect, the progestin chosen may be given continuously in low doses or sequentially in higher doses. Sequential dosing is usually for 10 or 12 days each calendar month. Progestins may be associated with unacceptable side effects, such as affective symptoms and weight gain. If estrogen is administered alone because of unacceptable side effects of progestins, then it is imperative to counsel the patient about the need for yearly endometrial biopsy.
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There are two principal regimens for hormone therapy.
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Continuous estrogen replacement with cyclic progestin administration results in excellent resolution of symptoms and cyclic withdrawal bleeding from the endometrium. One of the difficulties of this method of therapy is that many postmenopausal women do not want to continue having menstrual cycles. As a result, many physicians and patients choose to avoid the problem of cyclic withdrawal bleeding by the daily administration of both an estrogen and a low-dose progestin.
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There are two principal regimens for hormone therapy.
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Continuous estrogen replacement with cyclic progestin administration results in excellent resolution of symptoms and cyclic withdrawal bleeding from the endometrium. One of the difficulties of this method of therapy is that many postmenopausal women do not want to continue having menstrual cycles. As a result, many physicians and patients choose to avoid the problem of cyclic withdrawal bleeding by the daily administration of both an estrogen and a low-dose progestin.
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There are two principal regimens for hormone therapy.
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Continuous estrogen replacement with cyclic progestin administration results in excellent resolution of symptoms and cyclic withdrawal bleeding from the endometrium. One of the difficulties of this method of therapy is that many postmenopausal women do not want to continue having menstrual cycles. As a result, many physicians and patients choose to avoid the problem of cyclic withdrawal bleeding by the daily administration of both an estrogen and a low-dose progestin.
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There are a variety of estrogen preparations available. Most perimenopausal and menopausal women respond to one of these preparations, all of which ameliorate acute menopause symptoms and relieve vaginal atrophy. The administration of progestins for 10 to 12 days each month converts
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the proliferative endometrium into a secretory endometrium, brings about endometrial sloughing, and prevents endometrial hyperplasia or cellular atypia. Continuous progestin therapy may be used to produce endometrial atrophy.
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There are a variety of estrogen preparations available. Most perimenopausal and menopausal women respond to one of these preparations, all of which ameliorate acute menopause symptoms and relieve vaginal atrophy. The administration of progestins for 10 to 12 days each month converts
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the proliferative endometrium into a secretory endometrium, brings about endometrial sloughing, and prevents endometrial hyperplasia or cellular atypia. Continuous progestin therapy may be used to produce endometrial atrophy.
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