• Created by: jo bill
  • Created on: 20-12-14 15:32

The menopuase

  • progressive decline in ovarian function
  • symptomology due to loss of oestrogen - oophorectomy
  • marked by end of mensturation - 12 months after last period
  • FSH high, oestrogen low


  • vasomotor disturbances
  1. flushing, peripheral vasodilation
  2. nocturnal sweating and sleep problems
  3. headaches
  • urogenital atrophy
  1. wall of vagina thins and glands atrophy - reduced mucus
  2. similar changes in urethra and bladder - frequency and dysuria
  • physiological effects
  1. memory 
  2. mood and affect
  3. long term neurodegenration - alzhiemers
  • osteoporosis
  1. bone density decrease, deterioration of structure
  2. risk factors : white, smokers, low physical excercise, inadequate dietary Ca2+


replacement of hormones

  • oestrogen 
  1. loss gives rise to symptoms
  2. risk of endometrial hyperplasia and carcinoma

-synthesised natural oestrogens

-natural oestrogens from equine sources

  • progesterone: used in combination
  1. used in women with an intact uterus
  2. withdrawl from progesterone causes bleeding


  • vasomotor and physiological:-
  1. reduction in flushing, sleep broblems, sweats, headaches, palpitations
  2. very distressing : physiological benefit when reduced
  • urogenital ageing
  1. reduction in vaginal dryness : vaginal &urethral infections
  2. reduction in dysuria and urinary frequency
  3. replacing oestrogen helps regardless of route of admin
  • osteoporosis
  1. HRT delays bone loss and increasses none density in hip and spine - BUT needs to be taken for 7-to 10years
  2. effects wane rapidly on cessation
  3. oral and transdermal equally effective
  4. long term therapy licensed for prevention of osteoporosis
  • colorectal cancer
  1. reduction in incidence dependent on age of cohort and duration of treatment
  • coronary heart disease
  1. normal incidence rises post menopuase
  2. many studies but difficult to control all other…


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