Term
| How long does perimenopause last? |
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Definition
| 2-8 yrs, including the first year after menses completely stops |
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Term
| What happens during perimenopause? |
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Definition
~hormone levels rise and fall
~anovulatory cycles and resultant menstrual dysfxn
~cycle length decreases as there are fewer follicles to complete maturation, but menstruation is longer which can result in anemia
~mood changes
~changes in sexual dysfxn/ desire
~loss of bone
~changes in cholesterol control |
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Term
| As ovaries decline, they produce less estrogen which causes what? |
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Definition
| hot flashes and night sweats |
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Term
| What does the less production of progesterone lead to? |
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Definition
| is a factor in the menorrhagia |
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Term
| If there are no risk factors, what is the primary treatment of perimenopause? |
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Definition
|
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Term
| What can decrease the severity of hot flashes? |
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Definition
| SSRIs, clonidine and gabapentin |
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Term
| What can improve heavy bleeding during perimenopause? |
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Definition
| progestin supplementation |
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Term
| If the bleeding is dysfxnal, what surgical treatments are available? |
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Definition
hysterectomy or ablation AFTER pathology has been excluded
indicated when bleeding is BAAAD or if have BRCA gene |
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Term
| When does ablation treat dysfxnal bleeding? |
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Definition
| when bleeding is hormonal, does not work if the bleeding is fxnal (polyps) |
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Term
| If have estrogen without progesterone, what will happen? |
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Definition
| the endometrial lining will be too thick |
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Term
| What are some non-pharmaceutical treatments of perimenopause? |
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Definition
soy (with phytoestrogens)
estrogenic herbs
Progesterone cream from wild yams or chaste tree berry |
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Term
| HRT and ERT hormone replacement therapy reduce what? |
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Definition
reduce the risk of osteoporosis
reduce hot flashes
reduce the risk of heart dz
may improve mood and psychological well being. |
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Term
| ERT increases the risk of what? |
|
Definition
| cancer of the uterus due to unopposed estrogen |
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Term
| What are the unpleasant side effects of HRT? |
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Definition
bloating or irritability
can cause breakthrough bleeding which must be worked up |
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Term
| Long term use of HRT and ERT increases the risk of what? |
|
Definition
breast cancer
long term = 10 yrs, get them off HRT before that if possible |
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Term
| Is HRT and ERT dangerous in women with blood clots? |
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Definition
|
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Term
| IN WOMEN WITH A UTERUS PROGESTERONE MUST BE COMBINED WITTH ESTROGEN TO PREVENT ENDOMETRIAL HYPERPLASIA AND INCREASED RISK OF ENDOMETRIAL CANCER What is the only exception? |
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Definition
| estrogen creams which do not cause endometrial proliferation |
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Term
| Menopause is defined when there have been ___ full months with no period. |
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Definition
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Term
| With the exception of what, symptoms of perimenopause continue into menopause? |
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Definition
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Term
| What are the associated health risks with the onset of menopause? |
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Definition
changes in cholesterol
bone health
blood pressure
changes in urinary/ genital tracts due to estrogen deficiency
overall risk for cancer |
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Term
| For perimenopause, you ____ rely on hormone levels, and for menopause, you ______. |
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Definition
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Term
_______ levels of FSH and LH are consistent with ovarian failure
_______ levels are consistent with hypothalamic or pituitary causes |
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Definition
high
low~ in menopause, follicular decline and dysfxn decreases the ovaries' senstivity to FSH and LH so pituitary tres harder and secretes more |
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