Menopause
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Questions and Answers

What physiological change primarily marks the onset of menopause?

  • Permanent cessation of menses (correct)
  • Declining testosterone levels
  • Irregular menstrual cycles
  • Increased estrogen levels

    • What is the primary hormone level change that confirms menopause?

  • Decreased progesterone and increased estrogen
  • Decreased progesterone and LH
  • Increased testosterone
  • Increased FSH and LH (correct)

    • What should women be re-instructed about during the perimenopause period?

  • Contraceptive methods only
  • Hormone replacement therapy
  • Irregular menses
  • Breast self-examinations (correct)

    • Which symptom is commonly associated with the perimenopause phase?

    <p>Vaginal dryness and urinary issues</p> Signup and view all the answers

    What is the recommended frequency for Pap smear screenings after a woman has had three or more normal Pap smears in a row?

    <p>Every three years</p> Signup and view all the answers

    What risk does postmenopausal bleeding pose and necessitates evaluation?

    <p>Risk of vaginal malignancy</p> Signup and view all the answers

    Which health issue should be a focus for women during perimenopause?

    <p>Discussing sexually transmitted diseases</p> Signup and view all the answers

    What is a common manifestation during menopause that can lead to mood changes?

    <p>Fluid retention leading to breast tenderness</p> Signup and view all the answers

    What are common vasomotor symptoms experienced during menopause?

    <p>Hot flashes and night sweats</p> Signup and view all the answers

    Which of the following statements about Hormone Replacement Therapy (HRT) is true?

    <p>HRT can increase the risk of complications such as breast cancer.</p> Signup and view all the answers

    What condition is indicated by a decrease in vaginal lubrication during menopause?

    <p>Vaginal atrophy</p> Signup and view all the answers

    Which medication is particularly effective for treating vasomotor symptoms in menopausal women when HRT is contraindicated?

    <p>Venlafaxine</p> Signup and view all the answers

    What is the preferred treatment for a woman who has a uterus and ovaries regarding hormone therapy?

    <p>Estrogen/progesterone therapy</p> Signup and view all the answers

    What dietary supplement can help improve mood during menopause?

    <p>Vitamin B6</p> Signup and view all the answers

    What is a common side effect of black cohosh used for alleviating menopausal symptoms?

    <p>GI upset</p> Signup and view all the answers

    Which of the following statements about estrogen patches is correct?

    <p>They are contraindicated in patients with a history of breast cancer.</p> Signup and view all the answers

    What is a primary method for preventing osteoporosis in menopausal women?

    <p>Engaging in weight-bearing activities</p> Signup and view all the answers

    Which of the following should be limited to promote cardiovascular health?

    <p>Caloric intake and sugars</p> Signup and view all the answers

    What condition protects the vagina against infections before menopause?

    <p>Lactobacillus acidophilus</p> Signup and view all the answers

    What is a common symptom of vaginitis?

    <p>Itching and abnormal discharge</p> Signup and view all the answers

    What can contribute to the alteration of the internal environment leading to candidiasis?

    <p>Long-term use of birth control</p> Signup and view all the answers

    What dietary modification should a newly menopausal woman consider?

    <p>Increase whole grains and fruit</p> Signup and view all the answers

    What treatment is commonly used for candidiasis?

    <p>Miconazole</p> Signup and view all the answers

    What lifestyle change is recommended for maintaining cardiovascular health?

    <p>Engaging in 150 minutes of physical exercise per week</p> Signup and view all the answers

    Which of the following is NOT a risk factor for vaginal infections?

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

    What pH range is considered normal for the vagina?

    <p>3.5-4.5</p> Signup and view all the answers

    What is the primary cause of endocervicitis?

    <p>Chlamydia and Gonorrhea</p> Signup and view all the answers

    Which of the following describes Chlamydia?

    <p>An asymptomatic STI that can lead to serious complications if untreated</p> Signup and view all the answers

    What are the common symptoms of Chlamydia in females?

    <p>Cervical discharge, dyspareunia, and dysuria</p> Signup and view all the answers

    Which treatment is specifically recommended for pregnant women with Chlamydia?

    <p>Erythromycin</p> Signup and view all the answers

    Who should be screened annually for sexually transmitted infections?

    <p>All women aged 25 and younger who are sexually active</p> Signup and view all the answers

    At what age should girls receive the vaccination if they have not been previously vaccinated?

    <p>13-26 years</p> Signup and view all the answers

    What is a recommended practice for patients even after receiving the Gardasil vaccine?

    <p>Have annual Pap smears</p> Signup and view all the answers

    Which of the following medications is known to suppress symptoms and shorten the course of a herpes infection?

    <p>Acyclovir</p> Signup and view all the answers

    What is a common symptom of an initial herpes virus infection?

    <p>Painful itchy lesions</p> Signup and view all the answers

    How long can lesions from a herpes infection last before crusting over?

    <p>2-12 days</p> Signup and view all the answers

    Which of the following statements about condom use and STI transmission is accurate?

    <p>Condoms can reduce but not eliminate STI transmission</p> Signup and view all the answers

    In which areas can cancer related to STIs manifest after many years?

    <p>Vulva, vagina, penis, anus, and potentially throat</p> Signup and view all the answers

    What emotional responses are commonly experienced by patients dealing with STIs?

    <p>Anxiety and anger</p> Signup and view all the answers

    What are potential complications of untreated Chlamydia in females?

    <p>Conjunctivitis and pneumonia in newborns</p> Signup and view all the answers

    What is the recommended treatment for Chlamydia in pregnant women?

    <p>Erythromycin</p> Signup and view all the answers

    Which statement accurately describes testing for Chlamydia?

    <p>Urine culture or swab is used for diagnosis.</p> Signup and view all the answers

    Which organism is primarily responsible for causing endocervicitis?

    <p>Chlamydia</p> Signup and view all the answers

    What screening guideline is recommended for sexually active women aged 25 and younger?

    <p>Annual screening for STIs is recommended.</p> Signup and view all the answers

    What occurs during the perimenopause period?

    <p>Menstrual transition that can begin as early as 35 years of age.</p> Signup and view all the answers

    What is a significant reason for a woman to continue contraception until one year after her last menstrual period?

    <p>Because she may still be at risk for pregnancy.</p> Signup and view all the answers

    Which symptom is MOST closely associated with menopause due to hormonal changes?

    <p>Vaginal dryness and increased infections.</p> Signup and view all the answers

    Which hormone levels are typically increased to confirm menopause?

    <p>FSH and LH.</p> Signup and view all the answers

    What factor significantly contributes to the risk of osteoporosis in postmenopausal women?

    <p>Decreased estrogen levels leading to increased bone loss.</p> Signup and view all the answers

    What is the appropriate action if a woman experiences bleeding after menopause?

    <p>Consult a healthcare provider, as it could indicate vaginal malignancy.</p> Signup and view all the answers

    What is the recommended interval for Pap smear screenings for women with three or more normal tests?

    <p>Every 3 years or every 5 years with HPV test.</p> Signup and view all the answers

    Which factor contributes to mood changes during menopause?

    <p>Lack of sleep due to hot flashes.</p> Signup and view all the answers

    Which of the following symptoms is characteristic of bacterial vaginosis?

    <p>Gray-yellowish white discharge</p> Signup and view all the answers

    What is a common risk factor associated with trichomoniasis?

    <p>IV drug use</p> Signup and view all the answers

    Which of the following is a key diagnostic test for bacterial vaginosis?

    <p>Whiff test</p> Signup and view all the answers

    Which HPV types are most commonly associated with cervical cancer?

    <p>HPV 16 and 18</p> Signup and view all the answers

    What precaution should be taken when treating with metronidazole?

    <p>Avoid alcohol</p> Signup and view all the answers

    Which symptom is often noted as worsening after sexual intercourse in bacterial vaginosis?

    <p>Fishy odor</p> Signup and view all the answers

    Which treatment is recommended for external genital warts caused by HPV?

    <p>Podofilox or imiquimod</p> Signup and view all the answers

    What is one of the main complications of untreated bacterial vaginosis during pregnancy?

    <p>Premature delivery</p> Signup and view all the answers

    What lifestyle alteration is generally recommended for patients with trichomoniasis?

    <p>Wear cotton underwear</p> Signup and view all the answers

    What is a common symptom to look for when diagnosing trichomoniasis?

    <p>Frothy yellow-green discharge</p> Signup and view all the answers

    What is the recommended age range for girls to receive the HPV vaccine if they have not been vaccinated previously?

    <p>13-26 years</p> Signup and view all the answers

    What is the most effective prevention strategy against the spread of STIs, even though it does not eliminate the risk?

    <p>Condom usage</p> Signup and view all the answers

    Which of the following symptoms is most indicative of an initial herpes virus infection?

    <p>Fever and malaise</p> Signup and view all the answers

    What is the recommended frequency for Pap smears for vaccinated patients?

    <p>Every year</p> Signup and view all the answers

    Which of the following medications is NOT used to suppress symptoms of herpes infections?

    <p>Ibuprofen</p> Signup and view all the answers

    What is the typical duration for herpes lesions before they begin to crust over?

    <p>2-12 days</p> Signup and view all the answers

    What common emotional responses may patients experience when dealing with STIs?

    <p>Anxiety and anger</p> Signup and view all the answers

    How long may the initial herpes infection take to heal compared to recurrent episodes?

    <p>2-4 weeks for the initial, and 1 week for recurrent</p> Signup and view all the answers

    What is a critical lifestyle change to promote bone health in menopausal women?

    <p>Engage in weight-bearing activity</p> Signup and view all the answers

    Which of the following dietary recommendations is advised for maintaining cardiovascular health?

    <p>Follow the DASH diet</p> Signup and view all the answers

    What contributes to maintaining a normal vaginal pH before menopause?

    <p>Lactobacillus acidophilus</p> Signup and view all the answers

    What symptoms are most commonly associated with vaginitis?

    <p>Itching, irritation, and abnormal discharge</p> Signup and view all the answers

    Which factor is NOT a common risk for developing vaginal infections?

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

    Which medication is commonly used to treat candidiasis?

    <p>Clotrimazole</p> Signup and view all the answers

    What symptom is commonly reported during exacerbation of candidiasis?

    <p>Thick, cottage cheese-like discharge</p> Signup and view all the answers

    What is an important step for a patient experiencing recurrent episodes of candidiasis?

    <p>Monitor blood glucose levels for uncontrolled diabetes</p> Signup and view all the answers

    What is a recommended strategy for managing hot flashes during menopause?

    <p>Sleep in a cool room or use a fan</p> Signup and view all the answers

    Which of the following health promotion interventions is important for menopausal women?

    <p>Regular health screenings</p> Signup and view all the answers

    Study Notes

    Perimenopause

    • Menstrual transition begins an average of 4 years before the last period, usually around age 51, but can start as early as 35.
    • Symptoms include hot flashes, palpitations, irregular menses (heavier or lighter), vaginal dryness, and urinary issues.
    • Midlife health issues require attention to contraception, STDs, sexuality, and fertility.
    • Oral contraceptives are recommended as they help prevent uterine and ovarian cancers, anemia and alleviate perimenopausal symptoms.
    • Women need re-instruction on breast exams; contraception should continue until menstrual cycles have completely ceased.

    Menopause

    • Defined as the permanent cessation of menses, indicated by 12 consecutive months without bleeding.
    • Typically occurs between ages 41-59.
    • Hormonal changes include increased FSH and LH levels to confirm menopause.
    • Symptoms may include mood changes, breast tenderness, vaginal dryness, and hot flashes or palpitations.
    • Postmenopausal bleeding must be evaluated due to the potential for vaginal malignancies, such as endometrial cancer.
    • Recommended pap smear frequency: every 3 years after 3 consecutive normal tests or every 5 years with HPV testing.

    Clinical Manifestations

    • Increased bone loss post-menopause elevates osteoporosis risk; calcium, vitamin D, and weight-bearing exercise are essential.
    • Hot flashes, night sweats, and dizziness are common vasomotor symptoms.
    • Changing vaginal environment leads to infections; increased vaginal pH raises infection risk.
    • Utilize lubricants and stay hydrated to manage vaginal dryness.

    Medical Management

    • Hormone Replacement Therapy (HRT) used to alleviate menopause symptoms but has associated risks like heart attack and stroke; contraindicated in women with history of breast cancer, coronary disease, or blood clots.
    • Low-dose estrogen and progestin recommended for a limited duration; estrogen increases heart attack risk.
    • Alternative medications include Paroxetine, gabapentin, and venlafaxine for symptomatic relief.
    • Monitoring glucose levels is vital, as hormonal changes can influence blood sugar and increase fall risks.

    Nursing Management

    • Promote bone health through weight-bearing activities and calcium/D3 supplementation.
    • Advocate for cardiovascular health: maintain a BMI <25, manage blood pressure, and follow a DASH diet.
    • Nutritional therapy should include reduced saturated fats, increased whole grains, fruits, and calcium intake.
    • Average lifespan post-menopause is 30-35 years; regular health screenings are crucial.

    Vulvovaginal Infections

    • Normal vaginal pH ranges from 3.5-4.5; maintained by Lactobacillus acidophilus.
    • Frequent risk factors for vaginal infections include douching, prolonged antibiotic use, low estrogen levels, and personal hygiene neglect.

    Vaginitis

    • Involves inflammation/infection of the vagina; often caused by bacterial vaginosis, douching, or bubble baths.
    • Symptoms include itching, irritation, burning, and abnormal discharge.
    • Comfort measures: cool compresses, cotton underwear, and proper hygiene.

    Candidiasis

    • Caused by Candida albicans; symptoms include watery or thick discharge, pruritus, and increased redness.
    • Risk factors include birth control use and pregnancy; diagnosis confirmed via wet mount.
    • Treatment includes antifungal medications: miconazole, fluconazole, clotrimazole.

    Herpes Virus 2

    • Lifelong viral infection transmitted sexually and can occur even if asymptomatic.
    • Initial episode is usually more severe, with symptoms of itching, painful lesions, and flu-like symptoms.
    • Treatment focus is on suppressing symptoms using antiviral medications like acyclovir.

    Chlamydia

    • Most common STI, often asymptomatic; can lead to serious complications like PID, infertility, and neonatal issues.
    • Diagnosis via urine culture or swab; treatment typically involves Doxycycline or Azithromycin.
    • Screening recommended annually for sexually active women aged 25 or younger.

    Perimenopause

    • Begins approximately 4 years before the last menstrual period, typically around age 51 but can start as early as 35.
    • Symptoms include hot flashes, palpitations, irregular menstrual cycles, vaginal dryness, and urinary issues.
    • Women need to be informed about contraception, STDs, sexual health, and fertility during this time.
    • Oral contraception is preferred as it offers protection against uterine and ovarian cancer, anemia, and provides relief from perimenopausal symptoms.
    • Breast exam education should be reinforced.

    Menopause

    • Defined as the permanent cessation of menstruation after 12 consecutive months without a period.
    • Typically occurs between ages 41-59.
    • Serum hormone levels: increased FSH and LH confirm menopause.
    • Menstrual irregularities may signal the onset of menopause; contraception should continue until one year without menses.
    • Postmenopausal bleeding needs evaluation due to the risk of vaginal malignancy, including endometrial cancer.
    • Recommended pap smear: every 3 years after 3 consecutive normal tests, or every 5 years if combined with HPV testing.

    Clinical Manifestations During Menopause

    • Mood changes often stem from sleep deprivation due to hot flashes.
    • Symptoms can include breast tenderness, increased risk of vaginal infections, and hot flashes.
    • Notable increase in bone loss heightens the risk of osteoporosis.

    Nursing Management

    • Promote bone health through weight-bearing activities and calcium/D3 supplementation.
    • Support cardiovascular health by maintaining a healthy weight, blood pressure, and diet.
    • Encourage low-caloric and low-saturated fat diets.
    • Average life expectancy after menopause is 30-35 years.

    Patient Education

    • Advise against caffeine, alcohol, and spicy foods to mitigate hot flashes.
    • Discuss fall prevention strategies and the importance of regular health screenings to monitor conditions related to bone health and mood changes.
    • Suggest using lubricants for vaginal dryness and adjust sleeping environment to cool to alleviate hot flashes.

    Vulvovaginal Infections

    • Normal vaginal pH ranges from 3.5 to 4.5, maintained by lactobacillus acidophilus and glycogen, providing infection protection.
    • Risk factors for infections include frequent douching, long-term antibiotic use, low estrogen levels, and poor hygiene.

    Types of Vaginitis

    • Inflammation of the vagina leading to symptoms such as itching and abnormal discharge.
    • Treatment includes comfort measures such as cool compresses and avoiding irritants.

    Candidiasis (Yeast Infection)

    • Caused by Candida albicans, presenting with thick, cottage cheese-like discharge and severe itching.
    • Diagnosis involves identifying spores via microscopic examination and pH testing.
    • Treatment options include miconazole, nystatin, fluconazole.

    Bacterial Vaginosis

    • Results from anaerobic bacterial overgrowth with a fishy odor and grayish discharge.
    • Diagnosis via a whiff test and clue cells identification.
    • Complications can arise during pregnancy, increasing the risk of premature delivery and low birth weight.
    • Treatment includes metronidazole.

    Trichomoniasis

    • Caused by Trichomonas vaginalis with symptoms of frothy, yellow-green discharge.
    • Diagnosis includes visual inspection and pH evaluation.
    • Treatment options are metronidazole or tinidazole, with partner treatment necessary.

    Human Papillomavirus (HPV)

    • Common STI with various strains causing genital warts and cervical cancer (types 16 and 18 are particularly dangerous).
    • Education on vaccination is crucial: recommended for individuals aged 11-26.
    • Regular Pap smears are essential despite vaccination.

    Herpes Simplex Virus Type 2

    • Lifelong viral STIs with initial symptoms including painful lesions, often accompanied by flu-like symptoms.
    • Treatment involves antiviral medications like acyclovir to manage outbreaks.
    • Recurrent cases are usually milder than the initial episode.

    Endocervicitis

    • Inflammation caused by organisms such as Chlamydia and Gonorrhea, posing risks for ascending infections.

    Chlamydia

    • Most common STI, often asymptomatic in women but can lead to serious complications such as PID, ectopic pregnancy, and infertility.
    • Treatment typically involves doxycycline or azithromycin, with follow-up cultures recommended.
    • Healthcare providers routinely screen sexually active women under 25 annually.

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