Advancing Age And Menopause ppt
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Questions and Answers

What is the primary cause of menopause?

  • Cessation of menstruation due to lifestyle changes
  • Failure of ovarian follicular development despite gonadotropin stimulation (correct)
  • Overproduction of ovarian follicles
  • Increased levels of estrogen

Which demographic is suggested to experience a longer symptomatic window during menopause?

  • Black women (correct)
  • White women
  • Hispanic women
  • Asian women

What generally remains after menopause from the original number of follicles present at birth?

  • Approximately 5,000
  • Approximately 100
  • Approximately 50,000
  • Approximately 1,000 (correct)

What factor is associated with earlier menopause?

<p>Family history of early menopause (B)</p> Signup and view all the answers

What is the median age of perimenopause onset?

<p>47.5 years (D)</p> Signup and view all the answers

Which type of menopause is characterized by tissue destruction due to autoimmune factors?

<p>Autoimmune menopause (C)</p> Signup and view all the answers

What term describes the physiologic period in a woman's life during which there is regression of ovarian function?

<p>Climacteric (C)</p> Signup and view all the answers

What is the effect of atresia on follicular loss as women age?

<p>Atresia accelerates around age 37 (C)</p> Signup and view all the answers

What was the stated reason for stopping the Women's Health Initiative study early?

<p>Increased risk of invasive breast cancer due to combined hormone therapy (D)</p> Signup and view all the answers

What were the findings regarding estrogen plus progestin compared to placebo?

<p>Increased risk of breast cancer (D)</p> Signup and view all the answers

Which of the following treatments is approved by the FDA for managing hot flashes?

<p>Paroxetine (C)</p> Signup and view all the answers

What is the mechanism of action for bisphosphonates in osteoporosis treatment?

<p>Decrease osteoclast activity to reduce bone breakdown (C)</p> Signup and view all the answers

What long-term risk is associated with bisphosphonate use?

<p>Atypical femoral fractures (A)</p> Signup and view all the answers

Which statement is true regarding hormone replacement therapy for patients with a uterus?

<p>Estrogen must be combined with progestin (A)</p> Signup and view all the answers

What is a known side effect of taking bisphosphonates?

<p>Aggravation of esophagitis and gastritis (D)</p> Signup and view all the answers

How should clinicians approach hormone replacement therapy for symptomatic relief?

<p>Individualize the treatment based on each patient's needs (C)</p> Signup and view all the answers

What is the primary risk of prolonged unopposed estrogen therapy in postmenopausal women?

<p>Increased risk of breast cancer (C)</p> Signup and view all the answers

Which symptom is least likely to improve with intravaginal estrogen therapy for GUSM?

<p>Hot flashes (D)</p> Signup and view all the answers

What percentage of menopausal women are estimated to experience symptoms of vaginal atrophy?

<p>30-40% (B)</p> Signup and view all the answers

Which of the following is not a common risk factor for osteoporosis in postmenopausal women?

<p>Regular exercise (D)</p> Signup and view all the answers

What is the most common type of fracture in postmenopausal women?

<p>Vertebral fracture (D)</p> Signup and view all the answers

What potential side effect is commonly associated with hormone replacement therapy for menopausal symptoms?

<p>Unexplained vaginal bleeding (D)</p> Signup and view all the answers

Which hormone replacement therapy option is specifically recommended for treating local urogenital symptoms?

<p>Intravaginal estrogen therapy (B)</p> Signup and view all the answers

Which condition is characterized by urethral irritation, causing urgency and frequency without a urinary tract infection?

<p>Atrophic cystitis (A)</p> Signup and view all the answers

Which of the following factors is considered a contraindication for hormone replacement therapy?

<p>History of breast cancer (B)</p> Signup and view all the answers

What is the accelerated rate of bone loss typically observed in the first few years after menopause?

<p>1-2% per year (D)</p> Signup and view all the answers

Which type of hormone replacement therapy avoids the first pass effect, potentially lowering VTE risk?

<p>Transdermal patches (C)</p> Signup and view all the answers

What is a known effect of estrogen supplementation in postmenopausal women?

<p>Increased skin elasticity (D)</p> Signup and view all the answers

Which of the following statements about hormone therapy is correct?

<p>The lowest effective dose is always recommended for hormone therapy. (A)</p> Signup and view all the answers

Which of the following conditions is associated with an increased likelihood of menopause-related skin changes?

<p>Decreased epidermal thickness (A)</p> Signup and view all the answers

What primary change occurs to ovarian follicles during perimenopause?

<p>The number of follicles decreases substantially (C)</p> Signup and view all the answers

What is the primary hormone that inhibin suppresses?

<p>FSH (B)</p> Signup and view all the answers

What is typically observed in Day 3 FSH testing that indicates reduced ovarian reserve?

<p>FSH levels above 11 (B)</p> Signup and view all the answers

Which hormone ratio is expected to decrease after menopause?

<p>E2:E1 ratio (B)</p> Signup and view all the answers

What physiological change does a hot flash involve?

<p>Dilation of peripheral blood vessels (B)</p> Signup and view all the answers

At what age range does fertility in women typically begin to decline?

<p>Age 35-37 (A)</p> Signup and view all the answers

Which of the following is NOT a symptom associated with the decrease in estrogen during menopause?

<p>Increased fertility (B)</p> Signup and view all the answers

What happens to circulating estrogen levels during menopause?

<p>Decrease drastically (B)</p> Signup and view all the answers

What physiological change occurs in the cardiovascular system post-menopause?

<p>Increased incidence of coronary heart disease (A)</p> Signup and view all the answers

What primarily determines the signs and symptoms of menopause?

<p>Decreased estrogen levels (D)</p> Signup and view all the answers

Which organ systems are affected by the decline in estrogen during menopause?

<p>Multiple organ systems including cardiovascular, urogenital, and skeletal (A)</p> Signup and view all the answers

What is a common misunderstanding regarding estrogen level testing during menopause?

<p>Estrogen levels can reliably predict ovulation (B)</p> Signup and view all the answers

What physiological event does vasomotor instability during menopause lead to?

<p>Hot flashes (D)</p> Signup and view all the answers

Flashcards

Menopause

Permanent stopping of menstruation caused by ovarian follicle failure.

Climacteric

Period of life with gradual ovarian function decline.

Primary Ovarian Insufficiency

Early menopause (before 40) due to ovarian follicle depletion.

Median Menopause Age

Average age when menopause begins (around 51.4 years).

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Perimenopause

Transition phase before menopause, with symptoms.

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Atresia

Process of follicle death in the ovaries.

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Associated Factors (early menopause)

Factors including surgery, family history, smoking, and genetics potentially leading to earlier menopause.

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Associated Factors (late menopause)

Factors associated with later menopause, such as obesity and socio-economic status.

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Perimenopause

The transitional phase before menopause, characterized by erratic ovulation and menstrual cycle irregularity.

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Inhibin

A hormone that suppresses the release of FSH and LH, playing a crucial role in regulating the menstrual cycle.

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Day 3 FSH

A blood test measuring follicle-stimulating hormone (FSH) on the third day of a woman's menstrual cycle, used to assess ovarian reserve.

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Ovarian Reserve

The measure of a woman's remaining eggs and their quality.

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Menopause

The cessation of menstruation, marking the end of a woman's reproductive years.

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Estradiol

The dominant estrogen in premenopausal women, whose levels decrease during perimenopause and menopause.

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Hot Flash

A sudden feeling of warmth, often accompanied by sweating, that is a common symptom of menopause.

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FSH

Follicle-stimulating hormone, a hormone that stimulates the growth of ovarian follicles.

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LH

Luteinizing hormone, a hormone vital for ovulation.

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Estrogen levels

Estrogen levels fluctuate throughout a woman's life and plummet significantly during and after menopause.

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Postmenopausal

The period following menopause, defined by the absence of menstruation for at least 12 months.

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Clinical Manifestation

The observable changes in the body as a result of a disease or condition.

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Cardiovascular Disease

Diseases of the heart and blood vessels, the leading cause of death in women.

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Hormone levels

Levels of hormones, like estrogen and testosterone, change throughout a woman's life.

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Follicle Phase

Time during the menstrual cycle in which follicles develop.

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Androgen

Male sex hormones, including testosterone, that are also produced by women.

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Triglyceride Increase

Elevated levels of triglycerides in the blood.

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LDL Increase

High levels of low-density lipoprotein cholesterol.

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HDL Decrease

Lower levels of high-density lipoprotein cholesterol.

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Genitourinary Symptoms of Menopause (GUSM)

Symptoms affecting the genital and urinary tract during menopause, including atrophy, dryness and incontinence.

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Vaginal Atrophy

Thinning and shrinking of the vaginal lining.

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Menopause & Osteoporosis

Increased risk of osteoporosis due to hormonal changes during menopause.

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Postmenopausal Osteoporosis

Bone loss accelerates early after menopause, affecting mainly trabecular bone.

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HRT Contraindications

Medical conditions that preclude the use of Hormone Replacement Therapy.

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HRT Precautions

Conditions that requires extra caution when using HRT.

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Intravaginal Estrogen

Estrogen applied directly to the vagina.

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Intrarosa

Intravaginal DHEA insert.

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HRT Side Effects

Possible adverse effects of Hormone Replacement Therapy.

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Bioidentical HRT

Hormone replacement using plant-derived hormones.

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Unopposed Estrogen Risk

Risk to the uterine lining if estrogen is not balanced by progesterone.

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HRT Indications

Conditions where Hormone Replacement Therapy can be beneficial for menopausal symptoms.

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WHI Study Stop Reason

The Women's Health Initiative study stopped early due to increased breast cancer risk associated with combined hormone therapy (estrogen and progestin).

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WHI Breast Cancer Risk

Combined hormone therapy increased the risk of invasive breast cancer by 1.55 times compared to a placebo.

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WHI Heart Attack Risk

Combined hormone therapy increased the risk of heart attack.

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Bisphosphonate MOA

Bisphosphonates decrease osteoclast activity, thus reducing bone breakdown.

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Bisphosphonate Side Effects

Bisphosphonates can cause worsened esophageal and stomach inflammation (esophagitis/gastritis) and need to be taken on an empty stomach, followed by a wait period of at least 60 minutes.

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HRT Low Dose

Prescribe the lowest effective dose of hormone replacement therapy (HRT) to treat symptoms.

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HRT Uterine Patients

Avoid using estrogen alone in patients with a uterus (due to increased risk); combined therapy is necessary in those cases.

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Patient-Centered Approach

Individualize HRT decisions, considering the specific risks and benefits for each patient.

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