Menopause

?
Estrogen, progesterone and testosterone all decline as a woman ages.
T/F?
True
1 of 33
What are the 3 stages of menopause?
Peri-menopause
Menopause
Post-menopause
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When does menopause occur?
12 months after the woman's LMP
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Which surgical procedure would induce menopause regardless of the patient's age?
Hysterectomy
4 of 33
Why does chronic stress have an impact on menopausal symptoms?
raised cortisol levels can reduce oestrogen levels
5 of 33
Post-menopausal women receiving HRT are at higher risk of osteoporosis.
True/False?
False - lesser risk as oestrogen can increase bone formation
6 of 33
If the patient has had a hysterectomy or has the mirena coil, which HRT would be appropriate?
Estrogen only
7 of 33
Why is oestrogen only the most appropriate and not combined with progesterone?
Mirena coil - already contains progesterone component (levonorgestrel)
Hysterectomy - Progesterone is used to balance the risks of uterine cancer with oestrogen-only treatment - however no uterus then there is no risk
8 of 33
What are some factors that would influence the commencing/switching to estradiol transdermal preparation rather than oral?
Individual preference
BMI>30
GI disorder affecting absorption
Migraine
Previous/family history of VTE
Poor symptom control with oral
Gall bladder disease
Medication - enzyme inducers
9 of 33
What formulations do the transdermal preparations come in for estradiol?
Patch (Evorel)
Gel (Oestrogel)
Spray (Lenzetto)
10 of 33
What oral estrogen only pills are available?
Estradiol hemihydrate
- Elleste solo tablets
- Progynova tablets
11 of 33
Which therapy is used for peri-menopausal women who have not had a hysterectomy or minera?
Sequential
12 of 33
Name some oral sequential therapy.
Estradiol and norethisterone (Elleste Duet, Novofem)
Estradiol and dydrogesterone (Femoston)
13 of 33
What is the transdermal sequential therapy?
Estradiol and norethisterone (Evorel Sequi patches)
14 of 33
How does the sequential therapy work?
eostrogen is given every day whereas the progesterone component is only taken for around 2 weeks.
15 of 33
What does the safety of HRT largely depend on?
Age of patient
16 of 33
Should women <60 years of age be concerned about the safety profile of HRT?
No - benefits usually outweigh risks
17 of 33
What kind of therapy is used in post-menopausal women who still have a womb and do not have the mirena coil?
Continuous therapy
18 of 33
What is continuous therapy?
Patient is treated with a combination of oestrogen and progesterone every day without a break
19 of 33
Which oral preparations are available for continuous therapy?
Estradiol and dydrogesterone (Femoston-Conti)
Estradiol and norethisterone (Kliofem, Kliovance)
Estradiol and medroxyprogesterone (Indivina)
20 of 33
Which transdermal preparations are available for continuous therapy?
Estradiol and norethisterone (Evorel Conti patch)
Estradiol and levonorgestrel (FemSeven Conti patch)
21 of 33
Progesterone only tablet can be taken alongside transdermal estradiol.
T/F?
True
22 of 33
When should a review be carried out after commencing or changing HRT therapy?
3 months
23 of 33
What is the 3rd line hormone that can be added to therapy if there are distressing symptoms of low libido and other causes of this have been excluded?
Testosterone
24 of 33
Why should utrogestan be taken before bed?
Mildly sedative
25 of 33
Utrogestan (micronised progesterone) has a lower risk of which type of cancer compared to older synthetic progesterones?
Lower risk of breast cancer
26 of 33
Micronised progesterone is a natural progesterone - where is it derived from?
Plants
27 of 33
The younger the patient and if surgical menopause, the higher the need for testosterone replacement - Why is this?
Younger - have higher levels than women at normal menopausal age
Surgical - Sudden drop in testosterone
28 of 33
What can happen to the vagina due to menopause?
Lining becomes thin and dry
Elasticity declines
29 of 33
What symptoms can this cause in women?
Painful intercourse
Vaginal dryness
Low libido ?
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What can be used to alleviate these symptoms?
Estriol intravaginal creams (Ovestin)
Estradiol vaginal tablets - pessaries (Vagifem, Vagirux)
Estradiol vaginal ring (Estring)
Vaginal moisturisers/lubricants (Replens, YES)
31 of 33
These topical preparations can be used in combination with systemic HRT.
T/F?
True
32 of 33
The correct HRT is usually the 1st treatment that the patient is started on.
T/F?
False - On average takes 3 switches to get it right
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Other cards in this set

Card 2

Front

What are the 3 stages of menopause?

Back

Peri-menopause
Menopause
Post-menopause

Card 3

Front

When does menopause occur?

Back

Preview of the front of card 3

Card 4

Front

Which surgical procedure would induce menopause regardless of the patient's age?

Back

Preview of the front of card 4

Card 5

Front

Why does chronic stress have an impact on menopausal symptoms?

Back

Preview of the front of card 5
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Menopause study guide delves into hormone therapy, symptoms, and treatments for comprehensive understanding and management strategies.

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