Menopause and Climacteric Definitions

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Questions and Answers

What is the primary definition of menopause?

The phase of life characterized by endocrine, somatic, and psychological changes.

The period of regression of ovarian function in a woman's life.

A pathological cause of menstruation cessation.

The permanent cessation of menstruation due to ovarian follicular development failure. (correct)

What is the primary hormonal change after menopause?

An increase in FSH and LH. (correct)

An increase in inhibin.

A decrease in estrogen and progesterone.

A decrease in testosterone.

What is the most common symptom of vasomotor instability?

Mood swings.

Night sweats.

Weight gain.

Hot flashes. (correct)

Which group of women is less troubled by hot flashes?

Obese women. Signup and view all the answers

When do hot flashes typically begin in relation to menopause?

Within 3 months of menopause. Signup and view all the answers

How do hot flashes change over time?

They decrease in frequency and intensity. Signup and view all the answers

What is the effect of estrogen on cardiovascular health?

It is cardio-protective and increases HDL. Signup and view all the answers

What happens to the risk of cardiovascular disease after menopause?

It increases. Signup and view all the answers

What is a common psychological change associated with menopause?

All of the above. Signup and view all the answers

What is a common genitourinary change associated with menopause?

All of the above. Signup and view all the answers

What is the primary function of osteoclasts in bone metabolism?

Breaking down bone tissue Signup and view all the answers

What is the normal rate of bone loss per year after peak bone density in the 20s?

0.5% per year Signup and view all the answers

What is the approximate rate of bone loss per year during the first 5 years after menopause?

5% per year Signup and view all the answers

What is the hormone that inhibits osteoclastic bone resorption?

Calcitonin Signup and view all the answers

Which of the following is a risk factor for osteoporosis that cannot be changed?

Gender Signup and view all the answers

What is the approximate percentage of women who will suffer a vertebral fracture after the age of 65?

One third Signup and view all the answers

What is the most common site of fracture in osteoporosis?

All of the above Signup and view all the answers

What is the name of the hormone that stimulates osteoclastic bone resorption?

Parathyroid hormone (PTH) Signup and view all the answers

Which of the following is a modifiable risk factor for osteoporosis?

Smoking Signup and view all the answers

What is the approximate age by which one half of women will suffer a hip fracture?

90 years Signup and view all the answers

What happens to the vaginal walls after the loss of estrogen at menopause?

They become pale and thinner due to diminished vascularity Signup and view all the answers

What is the function of lactobacilli in pre-menopausal women?

To create a protective mechanism by metabolizing glycogen to produce acidic pH Signup and view all the answers

What is the effect of loss of estrogen on vaginal epithelial cells?

They contain less glycogen Signup and view all the answers

What is a symptom of genitourinary atrophy?

Dyspareunia Signup and view all the answers

What is the effect of estrogen replacement therapy on skin collagen?

It prevents and reverses skin collagen loss Signup and view all the answers

What is the primary cause of osteoporosis?

Imbalance between osteoclastic and osteoblastic activity Signup and view all the answers

What is the effect of menopause on vaginal rugae?

They disappear Signup and view all the answers

What is a psychological change associated with menopause?

Irritability and anxiety Signup and view all the answers

What is the percentage of skin collagen lost during the first five years of menopause?

30% Signup and view all the answers

What is a symptom of osteoporosis?

Increased bone fragility Signup and view all the answers

Study Notes

Menopause

Menopause is the permanent cessation of menstruation due to failure of ovarian follicular development in the presence of adequate gonadotropins.
Diagnosis of menopause is established when menstruation stops for 12 months in absence of an organic or a pathological cause.

Climacteric

Climacteric is the physiological period in a woman's life during which ovarian function regresses.
Menopause is only one aspect of the climacteric, during which time women undergo endocrine, somatic, and psychological changes that span several years.

Stages of Menopause

Pre-menopause
Climacteric
Post-menopause

Hormonal Changes After Menopause

FSH and LH are elevated >25 IU/L
Estrogen decreases
Decrease progesterone and inhibin
Testosterone is relatively increased

Clinical Changes

Menstrual changes
Vasomotor instability
Osteoporosis
Cardiovascular changes
Genitourinary atrophy
Psychological changes
Skin collagen changes

Menstrual Changes

Most women note a gradual tapering in both amount and duration of flow
A minority of women have more frequent and heavier bleeding
Abrupt cessation of menses is fairly rare

Vasomotor Instability (Hot Flashes)

Most common and troublesome symptoms for women at the climacteric
Obese women are less troubled by hot flashes than thin women
75% of women experience hot flashes within 3 months of menopause
Hot flashes lessen in frequency and intensity with advancing age

Cardiovascular Changes

Estrogen is a cardio-protective
Estrogen increases HDL and decreases LDL
Risk of cardiovascular disease increases after menopause

Genitourinary Atrophy

Vaginal walls become pale due to diminished vascularity and thin
Vaginal epithelial cells contain less glycogen, leading to loss of protective mechanism
Vagina loses its rugae and becomes shorter and inelastic

Symptoms of Genitourinary Atrophy

Dyspareunia
Vaginitis
Vaginal dryness
Dysuria
Urgency and frequency of urination
Supra-pubic pain

Psychological Changes

Irritability and anxiety
Depression
Lack of concentration
Change of libido
Alzheimer's disease

Skin Collagen Changes

Up to 30% of skin collagen can be lost during the first five years of menopause
Changes can be prevented and reversed with Estrogen Replacement Therapy (ERT)

Osteoporosis

Reduction of bone mass density with micro-architectural alteration and increase bone fragility
Imbalance between osteoclastic and osteoblastic activity (defective remodeling)

Risk Factors for Osteoporosis

Unchangeable factors:
- Gender
- Heredity
- Age
- Fracture history
- Medical conditions (e.g. hyperthyroidism, parathyroidism)
- Medications for chronic diseases (e.g. steroids)
Changeable factors:
- Calcium consumption
- Vitamin D intake
- Quit smoking or vaping
- Alcohol consumption
- Physical activity
- Posture
- Low body weight (BMI < 20)
- Some medications

Complications of Osteoporosis

Fractures
Most common sites of fracture are the vertebrae, femur neck, and distal radius
One-third of women will suffer vertebral fracture after 65 years of age and hip fracture by age 90

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Description

Learn about the definitions of menopause and climacteric, including the diagnosis and symptoms of menopause. Understand the physiological period of ovarian function regression in a woman's life.