Menopause Flashcards Preview

Y4 Obstetrics and Gynaecology > Menopause > Flashcards

Flashcards in Menopause Deck (23)
Loading flashcards...
1
Q

Define and describe perimenopause/climacteric

A
  • The time in which a woman has irregular cycles of ovulation and menstruation leading up to menopause and continuing until 12 months after her final period.
  • Usually begins in the 40s, but may start as early as the late 30s
2
Q

What are some of the symptoms of perimenopause?

A

Not not women experience symptoms to the same degree

  • Hot flashes,
  • Night sweats,
  • Weight gain
  • Mood changes e.g. depression
  • Vaginal dryness,
  • Vaginal pain, and pain with sexual intercourse and breast pain
  • Irregular menses
  • Irregular bleeding - intermenstrual bleeding, postmenstrual bleeding, some periods may be abnormally heavy (menorrhagia)
  • Headaches
3
Q

How long can the symptoms of the perimenopause phase and menopause last upto ?

A

Symptoms may begin up to 6 years before the final menstrual period and continue for a variable number of years after the final menstrual period

4
Q

Do women only recieve treatment of symptoms in menopause or do they also recieve treatment in the perimenopause phase if requried ?

A

The also recieve treatment for symptoms in the perimenopause phase if required so when talking about a treatments for certain symptoms I am talking about both in perimenopasue too although mainly menopause

5
Q

Define menopause

A

A biological stage in a woman’s life that occurs when she stops menstruating and reaches the end of her natural reproductive life. Usually it is defined as having occurred when a woman has not had a period for 12 consecutive months

6
Q

What causes the changes to occur in a women following menopause ?

A

The changes associated with menopause occur when the ovaries stop maturing eggs and secreting oestrogen and progesterone.

7
Q

What is the average age for menopause to occur ?

A

51

8
Q

What is defined as early menopause ?

A

Menopause occuring between 40-45yrs

9
Q

Define premature ovarian failure also known as premature menopause

A

Menopause occurring before the age of 40 years

10
Q

In general what are the causes of premature menopause ?

A

Natrually occuring or as a result of medical or surgical treatment.

11
Q

Define late menopause

A

Menopause occuring >54yrs

12
Q

Describe the physiology of menopause

A

As both the number and quality of egg cells in the ovaries decrease, the response of the ovaries declines, estrogen levels fall and levels of the hormones from the pituitary gland, Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) rise.

13
Q

What are the effects of oestrogen ?

A
  • Maintains female secondary sexual characteristics and glands e.g. breasts
  • Hair distribution, body shape & fat distribution
  • Effect on collagen
  • Stimulates bone and muscle growth
  • Stimulates endometrial thickening
  • decreases cholestrol - helps prevent CVD
14
Q

What are some of the bad effects of having oestrogen ?

A
  1. Oestrogen increases the chances of thromboembolitic disease (hence pill etc increses chances of clot)
  2. Increases the chances of breast cancer and endometrial (uterine cancer)
15
Q

What are some of the problems whcih arise due to menopause and not having oestrogen now ?

A
  1. Increased CVD risk
  2. Atrophy of oestrogen dependant tissues e.g. genitalia, breasts & skin - vaginal dryness can be a result of this
  3. Osteoporosis
16
Q

How is menopause diagnosed ?

A

Diagnose the following without laboratory tests i.e. clinical diagnosis in otherwise healthy women > 45 years with menopausal symptoms:

  1. Menopause in women who have not had a period for at least 12 months and are not using hormonal contraception
  2. Menopause based on symptoms in women without a uterus.
17
Q

When is perimenopause diagnosed and how ?

A

Diagnose the following without laboratory tests in otherwise healthy women aged over 45 years with menopausal symptoms:

  1. Perimenopause based on vasomotor symptoms (hot flushes and night sweats) and irregular periods
18
Q

When is serum FSH test used to diagnose menopause ?

A
  1. In women with suspected early menopause
  2. In women with suspected premature menopause
  3. Following hysterectomy with conservation of ovaries when there is no period pattern to observe, when unusual symptoms are present and when fertility appears to be reduced.
19
Q

Does a single raised serum FSH level confirm diagnosis of menopause ?

A

No you need to take at least 2 measurements 1 month apart - as there are other reasons for raised FSH levels

20
Q

What are some of the other causes of raised FSH levels/reasons for doing more than one test of serum FSH to confirm diagnosis ?

A
  • Released in pulsatile fashion
  • Raised just prior to ovulation
  • Raised with stopping COCP or depo,
  • Raised with breastfeeding or certain medication (SSRI)
21
Q

Should you use FSH serum test to diagnose menopause in someone on combined oestrogen and progestogen contraception or high-dose progestogen?

A

No

22
Q

What are some of the physical, psychological and sexual symptoms of menopause ? (note these present earlier)

A

Physcial

  • Hot flushes
  • Night sweats
  • Palpitations
  • Insomnia
  • Joint aches
  • Headaches

Psychological:

  • Mood swings
  • Irritability
  • Anxiety
  • Difficulty concentrating
  • Forgetfulness

Sexual:

  • Vaginal dryness
  • Libido
23
Q

What are some of the later symptoms of menopause?

A
  • Increase urinary frequency
  • Recurrent UTIs
  • Dysuria
  • Incontinence
  • Dry hair & skin
  • Atrophy of breast and genitals

Decks in Y4 Obstetrics and Gynaecology Class (63):