Menopause Questions with Correct Answers
Patient Case Correct Ans ✓✓ A 51-year old woman has frequent and
distressing hot flashes that interfere with her work and sleep, and vaginal
dryness that makes sexual intercourse with her husband uncomfortable.
She is otherwise healthy.
How should her case be managed?
Menopause Defined Correct Ans ✓✓ Cessation of ovarian function
leading to a state of permanent (>1 year) amenorrhea
Age Correct Ans ✓✓ Median age: 51 years
Age range: 45 - 55 years
Cigarette smokers: 2 years earlier
Ovarian senescence is gradual (~4 yrs)
Natural menopause vs. surgical menopause Correct Ans ✓✓
Hysterectomy
-uterus and one or both ovaries
,Menopause figure Correct Ans ✓✓
Menopause Correct Ans ✓✓ Sex steroids important for healthy
functioning of bones, brain, skin, and reproductive and urogenital tracts
Pathophysiology Correct Ans ✓✓ Born with 2 million primordial
follicles in ovaries
Normal life span has < 500 ovulations
Follicular atresia
Menopause: loss of ovarian function
Number of primordial follicles decrease with increasing age
Postmenopausal ovary secretes primarily androstenedione and
testosterone
No longer primary site of estradiol and progesterone synthesis
Other Nomenclature Correct Ans ✓✓
, Signs and Symptoms Correct Ans ✓✓ ***Some women do not have
symptoms
Clinical Presentation:
Sign and Symptoms slide Correct Ans ✓✓
Vasomotor Symptoms Correct Ans ✓✓ Major complaint
Hot flashes/flushes
-Increase pulsatile release of GnRH acute estrogen withdrawal small
increase in body temp vasodilation, flushing, sweating
Lasts from seconds to hours
Occur more often in *first 2 post-menopausal yrs* (get away with using
hormonal therapy the first few years)
Surgical menopause -> tend to be more intense
Vaginal Atrophy and Dyspareunia (painful intercourse) Correct Ans ✓✓
OTC lubricants
Replens
Luvena
Astroglide* -> only only approved
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