Term
| What are the major adverse effects of HRT |
|
Definition
- vaginal bleeding
- breast tenderness
- bloating (NOT weight gain)
- headache
- need to increase synthroid tx |
|
|
Term
| What are the major risks associated with HRT |
|
Definition
- thromboembolic events
- risk of stroke
- breast CA (nl after 5yrs d/c
- ovarian CA
- gallbladder disease (stones) |
|
|
Term
| What are the basic precepts of HRT |
|
Definition
- sx relief not dz prevention
- lowest dose, shortest time
- use caution with older pts
- add progesterone to estrogen if uterus present |
|
|
Term
| What administration precautions should be taken in pts w/ migraine, DM, or known thrombotic tendencies |
|
Definition
1) transdermal gel for these pts
2) cream for vaginal dryness alone |
|
|
Term
| Define: natural menopause |
|
Definition
| - dx after 12mo of amenorrhea not associated with a pathological cause |
|
|
Term
| Which of the gonadal hormones may be evaluated to support dx of menopause |
|
Definition
| - FSH levels rise dramatically because of lack of feedback estrogen production |
|
|
Term
| Describe menopausal transition |
|
Definition
- begins mid-40s
- lasts 4-5yrs |
|
|
Term
| Define: premature menopause |
|
Definition
| - final menstrual period before 40yrso |
|
|
Term
| What are risk factors for premature final menstrual periods |
|
Definition
- smoking
- low SES
- age of menarche
- parity
- previous OCP
- BMI
- ethnic origin
- FHx |
|
|
Term
| What is the mean age for menopause |
|
Definition
|
|
Term
| What ist he difference between "hot flush" and "hot flash" |
|
Definition
1) sensation of heat
2) episodes w/ sweating, sometimes followed by chill |
|
|
Term
| What ist he theory of the vasomotor sx of menopause |
|
Definition
| - reduced estrogen causees decreased endorphin concentrations, resulting in increased NE and 5HT release in thermoreg center to trigger inappropriate heat loss |
|
|
Term
| What are the major sisx of menopasue |
|
Definition
1) vasomotor sx*
2) vaginal dryness, itching, and dyspareunia*
3) anxiety/depression/mood changes
- urinary incontinence and leadkage
- sleep disturbances*
- cognitive changes
- somatic complaints
- sexual dysfxn |
|
|
Term
| What is the most effective treatment for vasomotor dysfunction in pts entering menopause |
|
Definition
|
|
Term
| What are non-hormonal pharmacologic agents that may be used to treat menopausal sx |
|
Definition
1) gabapentin: hot-flashes
2) paroxetine and venlafaxine (+/-)
3) clinidine: hot flashes (+/-) |
|
|
Term
What is the effect of the following on vasomotor sx of menopause:
phyto-estrogens
red-clover isoflavones
black cohosh |
|
Definition
1) +/-
2) -
3) -, w/ liver damage |
|
|
Term
| What is the treatment of vaginal dryness and dyspareunia |
|
Definition
| - intravaginal estradiol ring, estradiol tablet, estrogen vaginal cream |
|
|
Term
| What is the tx of sexual intrest changes in menopause |
|
Definition
|
|
