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27 Cards in this Set
- Front
- Back
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how we view menopause influences how we experience it
definition of menopause as metamorphosis |
atrophy and dysfunction or transformation. (womans genetial shrivel up) a transition to elder position some cultural
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Menopause definition
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retrospectively, one year w/o menses
avg. age is 50 perimenopause: 5 to 10 y surrounding menoupause starts at 40/45 |
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Surgical menopause
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any time ovaries are removed
acute menopause body can't ajdust so quickly if ovaries out dramatic change. put on HRT for short period of time. |
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Physiologic changes
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change in hormones
ovaries decrease amt of estrogen TSH&LH increase to try and get ovaries to produce estrogen. Hot flashes-due to irratic changes in levels of hormones |
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Physical changes
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cessesation of menses
increased hair growth-due to unopposed testosterone hot flashes vaginal dryness thinning of estrogen sensitive tissues infertility |
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Menses changes
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no normal
quick sudden end-have normal periods then stop-very unususal gradual tapering off-gradual decrease or further apart q3mo to 11mo to 3mo-can be heavy or scant bleeding may go almost a year then resume for awhile. |
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Menopausal symptoms timeline
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5 year block
hot flashes have these before anything else. then vaginal discomfort, then cardiac disese, then bladder discomfort, then osteoporosis |
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Hot Flashes patho
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unstable vasospastic response to fluctuatuing estrogen levels r/t noreepimetabolism in brain can last 2-5y or whole life
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hot flashes manifestations
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mild flush to intensely hot, several seconds to several minutes, rare to cluster can be accompained by perspiration, tension, anxiety, heart palpatations, nausea. nighttime is most bothersome
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Hot flash triggers
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ETOH
caffeine hot drinks stress/tension hot humid weather high acid foods bother them triggers are very individual some may have none at all |
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changes to estrogen sensitive tissue
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thinning of tissues:vaginal mucosa become thinner due to lack of estrogen
increase in UTI, monilia infections dysparunia-result of lack of use |
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Loss of bone with menopause
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starts before menopause gradual decline after 20's. Once menopause there is sharp decrease. men lose but not as fast.
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Hormone Replacement Therapy
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started in 30's with estrogen. if give estrogen w/o progesterone, >risk of endometrial CA.
START BEFORE MENOPAUSE suppossed < in CVD, Osteoporosis and hot flashes after PEMI study in 95 PREMARIN 4th most common rx in US |
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New thoughts on HRT
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2002 study showed > in CVD, Breast CA, FX, Colon CA, CVA, thromoembolic events
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So what have we learned about HRT
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don't use for prevention of CVD
tx duration and dose should be as short and low as poss. altenative rx for osteoporosis give only if reason if menopausal symptoms |
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Menses changes
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no normal
quick sudden end-have normal periods then stop-very unususal gradual tapering off-gradual decrease or further apart q3mo to 11mo to 3mo-can be heavy or scant bleeding may go almost a year then resume for awhile. |
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Menopausal symptoms timeline
|
5 year block
hot flashes have these before anything else. then vaginal discomfort, then cardiac disese, then bladder discomfort, then osteoporosis |
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Hot Flashes patho
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unstable vasospastic response to fluctuatuing estrogen levels r/t noreepimetabolism in brain can last 2-5y or whole life
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hot flashes manifestations
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mild flush to intensely hot, several seconds to several minutes, rare to cluster can be accompained by perspiration, tension, anxiety, heart palpatations, nausea. nighttime is most bothersome
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Hot flash triggers
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ETOH
caffeine hot drinks stress/tension hot humid weather high acid foods bother them triggers are very individual some may have none at all |
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what have we learned
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HRT should not be used for prevention of CVD
treatment and duration and dose should be as short and low as possible alternative rx for osteoporosis HERS and WHI data can't be extraploated to perimenopause or premature menopause woman USE HRT ONLY FOR MENOPAUSAL SX |
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Know your risk Factors
killers of woman over 50 |
CVD-esp if strong family hx
osteoporosis breast CA Colon CA risk/benefits of HRT know alternative rx choices |
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Self Care Choices
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EXERCISE: >endorphins, <bone loss, >HDL, < hot flashes
DIET-wt stabilization,<fat&animal protein,>fiber&CA vit D, E and C, <phosphates <ETOH <SMK <CAFFEINE >sex to help prevent dyspurnia |
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stress reduction
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visulaization
yoga tai chi therapeutic touch/massage acupunture elderly wt bearing exercise |
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what causes increase in number of falls in the elderly
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the change in center of gravity
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Alternative Rx
herbs |
Herbs:dong quai,ginseng and black cohosh tea all help body produce estrogen
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Alternative Rx
Pharmacologic |
megace-
catapres prozac effexor paxil SSRI |
