Term
| What is the definition of menopause? |
|
Definition
| Cessation of menstruation following the loss of ovarian function |
|
|
Term
| If a woman with intact ovaries has been amenorrheic for one year with no other cause, what is your diagnosis? |
|
Definition
|
|
Term
| What is the median age of menopause? |
|
Definition
|
|
Term
T or F
All women must have FSH and LH levels drawn to be diagnosed as menopausal. |
|
Definition
| False. The diagnosis is made when a patient has been amenorrheic for 12 months with no other etiology. |
|
|
Term
|
Definition
| Transitional period prior to menopause marked by irregular menses |
|
|
Term
| What is the hormonal hallmark of perimenopause? |
|
Definition
| Fluctuating estrogen levels |
|
|
Term
| What are some perimenopausal menstrual changes that you might see? |
|
Definition
lighter/heavier menses
skipped periods
irregular cycles
shorter cycles/longer cycles |
|
|
Term
What single diagnosis can be applied to the following women:
- surgical removal of ovaries
- intact ovaries but amenorrheic for one year
- hysterectomy with intact ovaries but estradiol level is menopausal?
|
|
Definition
|
|
Term
| Menstrual irregularites may be normal in perimenopause, however, we need to rule out other etiologies when indicated. What are some differentials to consider? |
|
Definition
- Pregnancy
- Thyroid dysfunction
- Fibroids
- Cancer-cervix or endometrial
- Contraceptive side effects or misuse
|
|
|
Term
| Common peri-menopausal and menopausal symptoms |
|
Definition
- Vasomotor- hot flashes, night sweats
- Insomnia
- Atrophy-vaginal, urethral, skin
- Mood changes/depression
- Cognitive changes
- Decreased libido
- Weight gain
- Ocular changes-reduced acuity, blurred vision
- Alopecia, hirsutism
|
|
|
Term
| Treatment options for perimenopausal women with vasomotor symptoms |
|
Definition
- Combined hormonal contraception
- Postmenopausal doses of estrogen/progestin
- Combining postmenopausal estrogen with DMPA or Mirena
- Non-hormonal options used for postmenopausal women
|
|
|
Term
| Lifestyle measures for hot flashes |
|
Definition
| smoking cessation, avoid triggers (spicy foods, chocolate), layer clothing (remove jacket during flash), control room temp and humidity, relaxation techniques and self-hypnosis, exercise |
|
|
Term
| Non-hormonal menopausal treatment for hot flashes: |
|
Definition
- Bellergal- approved for hot flashes, but addictive
- Gabapentin- may alleviate hot flashes, expensive
- Clonidine
- SSRI-venlafaxine, paroxetine, fluoxetine
|
|
|
Term
| OTC treatment for hot flashes |
|
Definition
| soy, red clover, black cohosh, dong quai, ginseng, evening primrose oil, chasteberry, vitamin E, kava |
|
|
Term
| Two forms of hormonal therapy (HT) for menopause treatment: |
|
Definition
- estrogen replacement therapy (ERT)- for women without a uterus
- estrogen/progestin therapy (EPT)- for women with an intact uterus
|
|
|
Term
| Forms of estrogen products: |
|
Definition
| oral, patch, ring, gels, creams, dietary |
|
|
Term
Menopause Treatment: oral conjugated estrogen (CE) and medroxyprogesterone acetate (MPA) |
|
Definition
|
|
Term
| Menopause treatment: oral ethinyl estradiol and norethindrone |
|
Definition
|
|
Term
| Menopause treatment: oral estrogen and testosterone |
|
Definition
|
|
Term
| Menopause Treatment: oral progestin |
|
Definition
- Medroxyprogesterone acetate-Provera
- Norethindrone- Aygestin
- Progesterone- Prometrium (contraindicated in peanut allergy)
- Mesgesterol acetate-Megace
- Norgesterel-Ovrette
|
|
|
Term
| 3 concerns about alternative therapies: |
|
Definition
Limited studies
Quality not dependable
Questionable product safety |
|
|
Term
| What race of women are at a higher risk for osteoporosis? |
|
Definition
|
|
Term
| What is one significant lifestyle habit that increases a woman's risk of osteoporosis and negatively impacts her general health status? |
|
Definition
|
|
Term
| What are 4 preventative recommendations you would make to your patient regarding bone health? |
|
Definition
- Maintain adequate calcium intake (1200mg)
- Maintain adequate vitamin D3 intake (400-800IU)
- Stop smoking
- Exercise-to increase muscle strength, balance, & bone architecture
|
|
|
Term
| What medications can increase the risk of osteoporosis? |
|
Definition
- corticosteroids
- anti-convulsants
- anti-coagulation agents
- immunosuppressive therapy
- levothyroxine
- lithium
|
|
|
Term
| The National Osteoporosis Foundation recommends screening woman over age___? |
|
Definition
|
|
Term
| Which test is more effective in screening for osteoporosis: X-ray or DEXA? |
|
Definition
| DEXA is more sensitive and specific. |
|
|
Term
The DEXA T score compares a woman's BMD to the average BMD of a healthy woman. Peak bone mass is "0."
When is a woman considered osteopenic?Osteoporotic? |
|
Definition
Osteopenia, T score= -1 to -2.5
Osteoporosis, T score = less than -2.5 |
|
|
Term
| Menopause Treatment: estrogen and progestin skin patch |
|
Definition
|
|
Term
| Menopause Treatment: estradiol vaginal ring |
|
Definition
|
|
Term
| Menopause Treatment: conjugated equine estrogen vaginal cream |
|
Definition
|
|
Term
| Menopause Treatment: estradiol patch |
|
Definition
Generic estradiol patch
Estraderm |
|
|
Term
| What is premature menopause? |
|
Definition
| Menopause that occurs before age 40 |
|
|
Term
| What are common reasons why women choose no medical treatment for menopause? |
|
Definition
| consider aging normal, afraid of risks with hormone use, unhappy with side effects of meds, symptoms are minimal |
|
|
Term
| Overview of bioidentical hormones |
|
Definition
compounded mixture of a variety of hormones (estradiol, DHEA, testosterone, progesterone)
dosage based on salivary levels or symptoms
not FDA regulated |
|
|
Term
| What is a frequent sexual problem reported by postmenopausal women? |
|
Definition
|
|
Term
| A postmenopausal woman tells you she experiences dyspareunia and avoids sex. What could you recommend to help with this issue? |
|
Definition
| Recommend a lubricant for coitus. Also counsel her that the lubricant will not increase her tissue elasticity. |
|
|
Term
| A postmenopausal woman reports to you that she uses lubricants for sex, but would like something to help with her vaginal dryness. What would you recommend if this was her only concern? |
|
Definition
| An intravaginal topical estrogen in the form of a cream, suppository, or ring can increase tissue elasticity and thickening. |
|
|
