Menopause 2 Flashcards Preview

Y4 Obstetrics and Gynaecology > Menopause 2 > Flashcards

Flashcards in Menopause 2 Deck (18)
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1
Q

What are the vasomotor symptoms in menopause ?

A

night sweats, hot flashes, and flushes

2
Q

What is the treatment of vasomotor symptoms in menopause ?

A

1st line - HRT therapy

3
Q

Who would you offer the combined oestrogen and progesterone HRT to and who would you offer the solo oestrogen replacement therapy to ?

A
  • Oestrogen and progestogen to women with a uterus
  • Oestrogen alone to women without a uterus.
4
Q

What is the treatment of menorrhagia which may occur in perimenopausal phase ?

A

1st line = mierena (progesterone)

2nd line = Tranexamic acid although contraindicated in thromboembolic disease (mefenamic acid if pain, more for reducing pain but both are often used together)

3rd line = progestogens or norethisterone

4th line = endometrial ablation

5
Q

What is the treatment of vaginal dryness in women with menopause (rememebr still talking about perimenopause if they get these symptoms)

A

Topical oestrogens

6
Q

What would you consider using to treat someone with psychological symptoms in menopause ?

A
  1. Consider HRT to alleviate low mood that arises as a result of the menopause.
  2. Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

No clear evidence for SSRIs to ease low mood in menopausal women who have not been diagnosed with depression - use if diagnosed with depression (refer to psychology)

Dad says that if in a women who doesnt want HRT then you would use SSRI and then refer for CBT (takes months to get someone CBT)

7
Q

What is the conservative management advice offered to all women experincing symptoms ?

A
  • Diet
  • Weight loss
  • Exercise
  • Lifestyle
  • Caffeine
8
Q

What is the benefit of HRT therapy over single treatment of symptoms in menopause ?

A

It alleviates most of the symptoms experienced in menopause

9
Q

If women experiencing vasomotor symptoms esp hot flushes but doesnt want to use HRT what would be the next treatment option?

A

Clonidine

10
Q

What are the benefits of HRT therapy ?

A
  • Reduction in vasomotor symptoms
  • Improvement in psychological symptoms
  • Improvement in urogenital symptoms - e.g. vaginal dryness and sexual function
  • Reduction in osteoporosis risk
  • HRT in women <60 decreases CVD risk
  • Reduced risk of bowel cancer
  • Possibly protective Alzheimer’s & Parkinson’s diseases
11
Q

What are the main risks of HRT therapy ?

A
  • Thromboembolic disease (VTE and PE),
  • Stroke
  • Breast cancer mainly once taken for over 5 yrs the risk increases - oestrogen only doesnt but combined does increase risk
  • Endometrial (uterine) cancer - increased risk with oestrogen only, but no increased risk with combined
  • Gallbladder disease.
12
Q

What are the contraindications to HRT therapy?

A
  • Pregnancy
  • Undiagnosed abnormal vaginal bleeding
  • Active or recent blood clot or myocardial infarction (heart attack)
  • Suspected or active breast or endometrial (womb) cancer
  • Active liver disease with abnormal liver function tests
  • Porphyria cutanea tarda
13
Q

What are the side effects of HRT therapy?

A
  • Bleeding -HRT taken in perimenopause, (usually combined) induces a monthly bleed in about 85% of women.
  • Nausea
  • Fluid retention
14
Q

What is the difference in HRT therapy for postmenopausal women and perimenopausal women ?

A

Cyclical HRT therapy for perimenopasusal women - this is where you take oestrogen every day and take progesterone only at certain times (cyclicly) - this often brings back someones periods

Continuous HRT therapy for postmenopasusal women (havent had period for 12months) - continuous oestrogen and progesterone taken everyday

15
Q

How is premature ovarian failure diagnosed ?

A

Diagnose premature ovarian insufficiency in women aged under 40 years based on:

  • menopausal symptoms, including no or infrequent periods (taking into account whether the woman has a uterus) and
  • elevated FSH levels on 2 blood samples taken 4–6 weeks apart.
16
Q

What is the recommended HRT therapy of women with

A

same normal menopause treatment as previously stated

17
Q

How long should HRT therapy in premature menopause be contuined until ?

A

50yrs old

18
Q

When can consideration into stopping HRT therapy for menopause be considered ?

A

roughly at 5yrs use some may continue though

Decks in Y4 Obstetrics and Gynaecology Class (63):