Menopause and Osteoporosis Flashcards
What is perimenopause
menopause transition and menopause
SS: menstrual cycle changes vasomotor instability vaginal dryness and genital tract atrophy sexual dysfunction sleep disturbance mood changes skin, hair, and nail changes
What is surgical menopause
Menopause induced suddenly and totally by removal of both ovaries prior to age of natural menopause
What are vasomotor instability
hot flashes
last 2-4 minutes
1-2 per day to one per hour
txt: lifestyle mods SSRI SNRI Gabapentin
What are GU changes with menopause
atrophy of estrogen-dependent tissues
atrophic vaginitis
endometrial atrophy
txt: vaginal moisturizers sexual activity local estrogen ospemifene (Osphena)
What is GU tract atrophy with menopause
paravaginal tissues atrophy and allow pelvic floor to relax
- cystocele
- rectocele
- uterine prolapse
urinary tract
- dysuria and urinary frequency
What is the timing of menopausal symptoms
vasomotor - usually first and wane after number of years
urogenital - become bothersome later
What is Primary Osteoporosis - Type I
postmenopausal
both sexes
loss estrogen - F
loss testosterone - M
trabecular bone primarily affected
MC - T6 - T9, T11 - L1
What is primary osteoporosis - type II
senile osetoporosis
> 75 yrs with poor calcium
trabecular and cortical bones affected
hip and pelvis MC
What is secondary osteoporosis
bone is lost due to other diseases
- steroids
- malignancy
- GI
- endocrine
- meds
- alcohol
What is osteopenia
T score of -1 to - 2.5
When screen for osteoporosis
postmenopausal and > 65
smoker
hx fracture after menopause
BMI
What meds affect bone mass
PPI anticoags anticonvulsants Thiazolidinediones Thyroid hormones Methotrexate Cancer drugs
What recommendations for Calcium for prevention and treatment
Prevent: 1000 - 1200 mg
Txt: 1200-1500 mg dived into 500 mg doses
What recommendations for Vit D
800 - 1000
loading dose 50,000 qwk x 8 - 12 wks
What are risks of combo HRT
No CV prevent CHD VTE Stroke Breast CA Lung CA
