Term
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Definition
- The years prior to menopause (when symptoms commence) and also the first year after menopause
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Term
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Definition
- Permanent cessation of menstruation which occurs when the ovaries stop producing the hormones estrogen and progesterone
- Natural menopause is recognised to have occurred once a period of 12 months has lapsed after the last menstrual period, and for which there is no other obvious cause
- No specific indication marks the beginning of menopause other than the onset of symptoms
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Term
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Definition
- When one year has lapsed since the last menstrual period
- Some women may still continue to experience menopausal symptoms for several years following their last period
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Term
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Definition
- Hallmark symptom of menopause
- Due to declining level of estrogen
- Body is now moving into a state of readjustment and learning to live without estrogen
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Term
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Definition
- A symptom that is regularly experienced
- Lining of vagina needs estrogen to stay lubricated and elastic
- Loss of elasticity causes dryness leading to uncomfortable intercourse
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Term
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Definition
- Urethra and bladder also rely on estrogen to function properly
- Loss of estrogen reduces elasticity causing problems such as increased need to urinate, pain or burning when urinating or bladder infections
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Term
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Definition
- Loss of interest in sex or reduced sex drive due to decreased estrogen levels, or as a result of tiredness and stress as the body changes its patterns
- Decreased libido due to decreased levels of androgens
- Vaginal dryness, a change in skin sensitivity, tiredness due to hot flushes, and the sense of just not wanting to be touched are other common factors
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Term
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Definition
- Signs and symptoms initially
- FSH can be used, but may not be clearly diagnostic until the pt is truly postmenopausal
- FSH > 12 means menopause is approaching
- FSH > 30 is typically considered diagnostic for menopause
- If symptoms are present but there is no FSH increase, consider thyroid disease
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Term
| When Should Estrogen Replacement Therapy Be Used? |
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Definition
| May only be used in women without a uterus |
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Term
| What is Hormone Replacement Therapy and when can it be used? |
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Definition
- Combination of estrogen and progestin
- Indicated only for perimenopausal symptoms or some cases of osteoporosis
- Must be used in women with intact uterus
- The only function of progestin is to protect against uterine hyperplasa
- Uterine hyperplasia is a strong risk factor for uterine cancer
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Term
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Definition
- Undiagnosed abnormal uterine bleeding
- History of estrogen-sensitive tumor (breast, uterus)
- History of thromboembolic disease (stroke, DVT, PE)
- Active liver disease
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Term
| Selection of Regimen: bleeding is heavy and irregular |
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Definition
- Try cyclic regimen first for cycle control
- May switch to continuous after one year
- Younger women tend to have less irregular bleeding with cyclic regimens
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Term
| Selection of Regimen: women who are amenorrheic or older than 50 |
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Definition
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Term
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Definition
- Postmenopausal ERT is typically dosed at much lower levels than OCP
- 0.625 mg conjugated estrogens = 5 mcg of ethinyl estradiol
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Term
| Addition of Androgens to HRT is approved for: |
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Definition
| Improving libido and hot flashes |
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Term
| Androgen Supplementation: ADR |
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Definition
- Worsens lipid profile
- May cause liver toxicity
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Term
| How long are androgens used in HRT regimens? |
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Definition
- Only used for 3-6 months to "kick start" the libido
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