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24 Cards in this Set
- Front
- Back
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Define menopause |
Permanent cessation of menses due to oocyte depletion in the ovaries |
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When do you make the diagnosis of menopause |
12 months after cessation of menses |
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Causes of menopause |
•Physiological •Others: chemotherapy, radiotherapy, surgery (bilateral oophorectomy) |
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Age range for menopause |
45-55 years, ave. is 51 |
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When is menopause said to be early |
When it occurs before the age of 45 |
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When is Menopause said to be premature |
If it occurs before the age of 40 |
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What is climacteric |
This is the period characterized by waning ovarian function |
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What is perimenopause |
Period from onset of climacteric to years after the last menses |
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Average duration of menopausal transition (climacteric & perimenopause) |
4 years |
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When in the life of a female do you have the peak number of primordial follicles |
5 months. About 2 million primordial follicles |
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Levels of FSH in menopause is |
Increased |
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Clinical effects of menopause can be classified as |
•short term •intermediate •long term |
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Short term effects of menopause |
•irregular menses •hot flushes •irritability •mood swings •poor sleep •loss of concentration |
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Intermediate effects of menopause |
•vaginal dryness •sexual difficulties - dyspareunia |
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Long term effects of menopause |
•osteoporosis •cardiovascular problems •urogenital atrophy |
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Gold standard for treating hot flushes |
Hormone replacement therapy. Low doses of estrogen used for short period |
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Non hormonal drugs that can be used to treat for vasomotor symptoms |
•antidepressants •propranolol •GABA agonist •evening primerose oil •herbal preparations -black cohosh -red clover |
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Treatment of osteoporosis |
•HRT •Sselective estrogen receptor modulator: raloxifene •bisphosphonates: Alendronate, Risedronate •Calcitonin •Parathyroid hormone •Tibolone |
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Treatment of urogenital atrophy |
•estrogen creams •vaginal lubricants |
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Complications of hormone replacement therapy |
1. Risk of cancers •breast cancer •endometrial cancer 2. Cardiovascular diseases •myocardial infarction •thrombosis |
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Contraindications to hormone replacement therapy |
1. Absolute • Pregnancy • Uninvestigated abnormal vaginal bleeding • Breast cancer or other estrogen-dependent tumours • Venous tjromboembolic disease • Myocardial infarction or unstable angina • Severe liver disease 2. Relative • CVA • Severe migraine • Thrombophilia |
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Routes of administration of hormone replacement therapy |
•oral preparations •transdermal patches or gels •implants •local preparations |
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Physiology of menopause |
The peak number of primordial follicles is present at 5 months intrauterine life, about 2 million primordial follicles. At birth this has reduced by 50% At puberty, less than 25% will remain There is constant depletion of ovarian follicles as they undergo atresia |
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Hormone levels in menopause |
Reduced estradiol and inhibin Increased FSH LH initially normal but eventually rises GnRH is increased Testosterone initially normal but eventually decreases due to ageing adrenal cortex |
