Menopause and Hormone Therapy study
test guide with complete solution
What is the final cessation of menstruation? - Menopause
Average age of menopause in Western societies? - 51 years
Two ways to undergo menopause? - Naturally (Part of aging)
Surgical (Result of bilateral oophorectomy)
What is perimenopause? - The "menopause transition years" (1-3 years before and after last
period) when hormone levels are still fluctuating
What symptoms might a perimenopausal woman have? - Hot flashes
Night Sweats
Vaginal dryness
What is diagnostic of ovarian failure in menopausal women? - Consistently elevated FSH
What is the most significant factor in the production of menopausal symptoms? - Decrease in
estrogen
What happens to cycles as menopause approaches? - Cycles become longer and more
irregular
What happens to the menstrual flow as menopause approaches? - It starts to diminish and will
eventually start to stop or only have spotting
How long after the last menstrual period has occurred can you say that the transition to
menopause has occurred? - 1 year
A patient comes in complaining of spotting. She finds this unusual because she hit menopause
3 years ago. What do you need to rule out? - Cervical Ca
ANY BLEEDING AFTER MENOPAUSE IS ABNORMAL
Describe hot flashes: - Feeling of intense heat over the trunk and face, with flushing of the skin
and sweating
How long do hot flashes typically last? In what patients are they worse in? - Typically 2-3 years
,Worse in surgical menopause patients
What two things happen within the vagina as a result of menopause? - Thinning of the vaginal
mucosa
Decrease vaginal lubrication
What will you find on pelvic exam in a patient with vaginal atrophy? - Smooth vaginal mucosa
Clinical symptoms of menopause? - Cessation of menstruation
Hot flashes
Vaginal atrophy
Osteoporosis
What is the most common initial manifestation of perimenopause? - Hot flashes
Women with hot flashes are more likely to experience what feelings compared to asymptomatic
women? - Disturbed sleep
Depressive symptoms
Reductions in quality of life
Two classes of medication you can use to treat vasomotor symptoms of menopause? -
Estrogen or estrogen/progesterone regimens
SSRIs
If a patient undergoes estrogen or estrogen/progesterone therapy for vasomotor symptoms,
what is the maximum length of time they should be on them? - No more than 3 or 4 years
The Women's Health Initiative states that women using long term combination
estrogen-progestin therapy have an increased risk of what things? - Cardiovascular disease
CVA
Breast CA
What can you use to relieve feelings of vaginal atrophy? - Estradiol containing vaginal ring
Estrogen vaginal cream (short term)
Water soluble gel for dyspareunia
How much calcium should women be ingesting everyday throughout life? - At least 800mg
Once a woman reaches menopause, how much elemental calcium should they take? -
1200mg every day
Hormone replacement in post-menopausal women has been shown to help prevent what? -
Hip fractures
, What increases calcium absorption? - Vitamin D from food or sunlight
What type of exercise maintains bone mass? - Weight bearing exercise
What effects will women who undergo surgical menopause experience immediately? - Rapid
onset, severe vasomotor symptoms, dyspareunia, and osteoporosis
What are women started on immediately following a bilateral oophorectomy? - Estrogen
replacement therapy to decrease the severe symptoms
what is the gold standard for treatment of hot flashes - ANS hormone therapy
does hormone therapy cause breast cancer - ANS no
lack of estrogen in the vaginal and urethral area causes an increase in what complications -
ANS UTI
Hormone therapy is effective at the prevention of what - ANS osteoporosis
If a women has a family history of breast cancer is this a contraindication for starting hormone
therapy - ANS no
does menopause affect lipid levels - ANS yes
Should you discourage the use of hormone therapy in postmenopausal women - ANS no
defined as the span of time from puberty to perimenopause - ANS premenopause
defined as the span of time that begins with the onset of menstrual cycle changes and other
menopause s/s and extend through menopause to 1 year after menopause - ANS
perimenopause
when does the time frame known as perimenopause begin - ANS when a pt begins
experiencing menstrual cycle changes and other menopause related s/s
who long does the perimenopause period usually last - ANS 6-10 years
perimenopause begins with the changing of the menstraul cycle and menopause s/s and
continues until when - ANS through menopause and 1 year after menopause
what is another name for the peri menopause period - ANS menopause transitions (MT)
defined as the the final menstrual period which can be confirmed after going 12 consecutive
months without a period - ANS menopause
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