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37 Cards in this Set
- Front
- Back
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What is perimenopause?
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From the onset of irregular bleeding until 1 year after the Last Menstrual Period (LMP)
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What is menopausal transition?
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The time before the menopause when cycles exhibit variability
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What is menopause?
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The permanent cessation of menses secondary to loss of ovarian follicular activity
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What does hormone therapy consist of?
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Estrogen and Progesterone
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What does estrogen therapy consist of?
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Estrogen alone (duh)
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What is the normal duration of the menopause transition?
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2-8 years
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What are the 3 major clincal features of menopause transition?
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1. Change in menstruation
2. Vasomotor symptoms (hot flashes) 3. Vaginal Atrophy |
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When do hot flashes / vasomotor symptoms usually present?
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Right before period
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What causes vaginal atrophy?
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Low estrogen
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What happens to ovarian function during menopause?
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Becomes less reliable, basically runs out of follicles
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Due to decreased ovarian function, what happens to LH/FSH levels?
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Increase because no negative feedback
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What causes the decreased estrogen levels of menopause?
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Decreased follicle number and decreased ovarian inhibin
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What can be given to patients to provide relief from menstrual irregularities and vasomotor symptoms?
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Lower dose oral contraceptives
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What is the MOA of lower dose oral contraceptives?
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Basically turn off ovaries
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A women's risk of what is decreased when taking OC?
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Decreased risk of endometrial and ovarian cancer
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What % of women experience hot flashes?
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60%
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What exacerbates hot flashes?
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Caffeine, alcohol, stress
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Hot flashes can be treated with what?
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Hormone Therapy (HT)
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What is the only peri-menopause symptoms that doesn't resolve with time?
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Vaginal Atrophy
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What symptoms are seen in terms of body shape and hair in menopause?
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Hair - loss of hair
Skin - acceleration of skin aging Shape - Pear --> apple shape |
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Are memory issues caused by menopause?
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Yes, but hard to differentiate from normal aging
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What is one "good symptom" of menopause?
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No more periods
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lack of ovarian function + aging = what?
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Chronic diseases affected by menopause
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What is one of the main increased risks seen in menopausal women?
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Increased risk of osteoporosis
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What are 5 risk factors for osteoporosis?
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1. Thin, skinny body type
2. Physical inactivity 3. Hyperthyroidism or thyroid hormone medication 4. Steroid use 5. Low calcium |
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What are some treatments for preventing osteoporosis?
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1. Reinfornce with calcium/Vit D
2. Screen for bone densities 3. HT 4. Fall prevention |
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Apart from osteoporosis, what else are menopausal women at risk for?
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Coronary Artery Disease (CAD)
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What changes in menopause that contributes to elevated risk of CAD?
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Increase in total cholesterol and LDL with decrease in HDL due to LOW estrogen
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How does estrogen effect liver metabolism of cholesterol?
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Favoring more HDH and less LDL
(thus when E gone, this reverses) |
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How does low estrogen affect coronary arteries?
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Decreases elasticity and increases plaque formation
(via no increase in vasodilation) |
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Historically, what was the thought about HT and CAD disease?
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Most data showed HT associated with decreased risk of CAD and favorable effects on lipids
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What did the WHI (women health initiative) show wrt to CAD and COMBINATION HT?
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1. Increased Breast cancer
2. INcreased MI's 3. Increased stroke 4. Increased DTV |
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Were these same association seen in the estrogen only arm?
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NO (only stroke had a significant increase)
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Did estrogen only HT increase breast cancer risk
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NO, actually decreased it
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Why should women get their calcium from diet and not supplements?
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Increased kidney stones in women taking calcium supplements
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Small RCT's show what psychiatric medication can be effective in reducing hot flashes?
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SSRI's
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When should alternative treatments be used?
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When patients have exhausted all traditional options for symptoms relief
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