Physical Therapy for Women: Menopause and Osteoporosis
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Questions and Answers

What is the effect of spontaneous decrease in activities, energy expenditure, and metabolic rate?

  • Increased risk of type II DM (correct)
  • No effect on metabolic disorders
  • Increased risk of type I DM
  • Reduced risk of metabolic disorders

    • What is the effect of estrogen on the brain?

  • Estrogen has no effect on the brain
  • Estrogen receptors are present all over the brain (correct)
  • Estrogen receptors are only present in the hippocampus
  • Estrogen only affects the cerebral cortex

    • What is the effect of decreased estrogen levels on the vagina?

  • Increased lubrication and thickening of mucosa
  • No effect on vaginal mucosa
  • Thickening of mucosa leading to dyspareunia
  • Atrophy and thinning of mucosa leading to irritation and itching (correct)

    • What is the significance of FSH levels above 10 IU/L?

    <p>Declining ovarian function</p> Signup and view all the answers

    What is the effect of estrogen on cardiovascular circulation?

    <p>Protective effects on circulation and blood vessels</p> Signup and view all the answers

    What is the effect of estrogen fluctuations and withdrawal on the body?

    <p>Hot flashes and vasomotor changes</p> Signup and view all the answers

    What is the effect of decreased estrogen levels on the uterus?

    <p>Endometrial hyperplasia</p> Signup and view all the answers

    What is the effect of decreased estrogen levels on pelvic floor muscles and ligaments?

    <p>Decreased muscle tone and elasticity, leading to PFD</p> Signup and view all the answers

    What percentage of women are affected by vasomotor changes?

    <p>85%</p> Signup and view all the answers

    What is the duration of hot flashes?

    <p>1 minute to several minutes</p> Signup and view all the answers

    What is a symptom of hot flashes besides heat waves?

    <p>All of the above</p> Signup and view all the answers

    When can hot flashes begin in women?

    <p>In the late reproductive years, becoming more symptomatic in early menopause, late menopause, and the early post menopause period</p> Signup and view all the answers

    What is the most effective treatment for vasomotor symptoms?

    <p>Hormonal therapy</p> Signup and view all the answers

    What is a recommended lifestyle modification for reducing mild vasomotor symptoms?

    <p>Dressing in layers</p> Signup and view all the answers

    What is the effect of estrogen on the musculoskeletal system?

    <p>Increases calcium absorption from the intestine</p> Signup and view all the answers

    What is osteoporosis defined as?

    <p>Low bone mineral density leading to compromised bone strength</p> Signup and view all the answers

    What is the primary mechanism by which exercise improves cardiovascular health?

    <p>Increased endurance through aerobic exercises</p> Signup and view all the answers

    What is the recommended frequency of exercise for obesity?

    <p>Three times a week</p> Signup and view all the answers

    What is the primary biological effect of exercise on bone?

    <p>Increased osteoblastic activity</p> Signup and view all the answers

    What is the primary mechanism of electrotherapy on bone?

    <p>Piezoelectric effects</p> Signup and view all the answers

    What is the recommended duration of electrotherapy for bone growth?

    <p>1 hour a day</p> Signup and view all the answers

    What is the recommended intensity of exercise for cardiovascular health?

    <p>60% of VO2max</p> Signup and view all the answers

    What is the primary mechanism of exercise on depression?

    <p>Increased serotonin and norepinephrine levels in the brain</p> Signup and view all the answers

    What type of exercise is recommended for osteoporosis?

    <p>Weight-bearing exercises</p> Signup and view all the answers

    What is the primary goal of hormonal replacement therapy in menopausal women?

    <p>To relieve symptoms of menopause</p> Signup and view all the answers

    What is a contraindication for hormonal therapy in menopausal women?

    <p>Uncontrolled hypertension</p> Signup and view all the answers

    What is the benefit of electrotherapy in menopausal women?

    <p>Relief of symptoms</p> Signup and view all the answers

    What is the purpose of calcium intake in menopausal women?

    <p>To prevent osteoporosis</p> Signup and view all the answers

    What is the role of exercises in menopausal women?

    <p>To improve cardiovascular health</p> Signup and view all the answers

    What is the benefit of selective estrogen receptor modulators (SERMs) in menopausal women?

    <p>Prevention of osteoporosis</p> Signup and view all the answers

    What is the purpose of examination in menopausal women?

    <p>To rule out underlying medical conditions</p> Signup and view all the answers

    What is a potential benefit of hormonal therapy in menopausal women?

    <p>Decreased risk of colonic cancer</p> Signup and view all the answers

    What is the definition of menopause?

    <p>The cessation of menstruation for at least one year due to intrinsic ovarian failure.</p> Signup and view all the answers

    What is the primary difference between menopause and climacteric events?

    <p>Menopause is a specific event, while climacteric is a period of gradual changes.</p> Signup and view all the answers

    What is the name of the period that begins around 4 years before the last menstrual period (LMP)?

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

    What is the result of the decline in ovarian function during menopause?

    <p>Follicular inactivity</p> Signup and view all the answers

    Why is it important to detect climacteric events?

    <p>To assess the effects of estrogen on women's health.</p> Signup and view all the answers

    What is the definition of postmenopausal?

    <p>The period after menopause.</p> Signup and view all the answers

    What happens to fertility during perimenopause?

    <p>It decreases</p> Signup and view all the answers

    What is the purpose of detecting and managing climacteric events?

    <p>To prevent the consequences of menopause.</p> Signup and view all the answers

    Study Notes

    Menopause

    • Menopause is defined as the permanent cessation of menstruation for at least 6 months to one year due to intrinsic ovarian failure, resulting in follicular inactivity.
    • Climacteric is a period of gradual changes (decline) of ovarian function, starting long before menopause and continuing thereafter for a while.
    • Climacteric period includes perimenopause, menopause, and postmenopause.

    Different Types of Menopause

    • Natural menopause: occurs when ovaries naturally stop producing eggs.
    • Premature menopause: occurs when ovaries stop producing eggs before the age of 40.
    • Induced menopause: occurs when ovaries are surgically removed or damaged by radiation or chemotherapy.

    Changes Occurring in Menopause

    • Hyperfunctioning of pituitary gland anterior lobe, leading to increased appetite and altered carbohydrate metabolism.
    • Spontaneous decrease in activities, energy expenditure, and metabolic rate.
    • Increased risk of type II diabetes.

    CNS and Psychological Changes

    • Impairment of mental functions, causing dementia.
    • Anxiety, mood swings, and sleep disturbances.
    • Depression due to decreased serotonin synthesis and increased catabolism.

    Genitourinary System Changes

    • Ovaries: become small, fibrous, and unresponsive to gonadotropins.
    • Uterus: becomes small, with endometrial hyperplasia.
    • Vagina: atrophy and thinning of mucosa, leading to irritation, itching, and dyspareunia.
    • Pelvic floor muscles and ligaments: decreased muscle tone, decreased elasticity, and pelvic floor dysfunction.

    Endocrinal Changes

    • FSH levels: increase (> 10 IU/L) with declining ovarian function, and increase further (> 20 IU/L) with ovarian insufficiency.
    • Estradiol levels: decrease with ovarian insufficiency.
    • Inhibin levels: decrease, leading to increased FSH production.
    • Anti-Mullerian hormone: becomes undetectable.
    • Progesterone levels: decrease.
    • Androgen levels: increase.

    Cardiovascular Changes

    • Protective effects of estrogen on circulation and blood vessels are lost.
    • Atherosclerosis, hypertension, and strokes may occur.
    • Vasomotor changes (hot flashes) occur due to estrogen fluctuations and withdrawal.

    Vasomotor Changes (Hot Flashes)

    • Hot flashes affect around 85% of women and present as episodic heat waves, followed by cold sweats.
    • Hot flashes can disturb sleep, leading to increased heart rate, palpitation, headache, and dizziness.
    • Grading of hot flashes is important for planning management and follow-up.

    Musculoskeletal Changes

    • Protective effects of estrogen on the musculoskeletal system are lost.
    • Estrogen deprivation leads to increased frequency of knee, hip, and finger osteoarthritis.
    • Identified estrogen receptors (ERs) in normal and osteoarthritic cartilage.
    • Musculoskeletal pain increases pre and post menopause.

    Osteoporosis

    • Osteoporosis is defined as low bone mineral density, leading to compromised bone strength.
    • Advanced age and decreased estrogen production lead to decreased bone mass.
    • Exercises, supplements, nutrition, and counseling can help prevent osteoporosis.

    Management of Menopause

    • Treatment options include hormonal replacement therapy, selective estrogen receptor modulators (SERMs), and medical therapy.
    • Prevention strategies include lifestyle modifications, physical exercises, and electrotherapy.
    • Hormonal therapy is indicated for symptomatic menopausal women, premature or induced menopause, and preventing osteoporosis.
    • Contraindications for hormonal therapy include breast or endometrial cancer, active liver disease, uncontrolled hypertension, and thromboembolic diseases.

    Hormonal Therapy

    • Benefits of hormonal therapy include symptoms relief, prevention of urogenital atrophy, and decreased risk of colonic cancer.
    • Physical exercises can help with cardiovascular health, obesity, depression, and osteoporosis.
    • Electrotherapy options include electromagnetic field, pulsed ultrasound, and ultraviolet device.

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    Description

    This quiz covers the concepts of menopause, climacteric events, types of menopause, osteoporosis, and its risk factors, prevention, and management.

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