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Questions and Answers
What is the effect of spontaneous decrease in activities, energy expenditure, and metabolic rate?
What is the effect of estrogen on the brain?
What is the effect of decreased estrogen levels on the vagina?
What is the significance of FSH levels above 10 IU/L?
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What is the effect of estrogen on cardiovascular circulation?
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What is the effect of estrogen fluctuations and withdrawal on the body?
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What is the effect of decreased estrogen levels on the uterus?
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What is the effect of decreased estrogen levels on pelvic floor muscles and ligaments?
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What percentage of women are affected by vasomotor changes?
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What is the duration of hot flashes?
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What is a symptom of hot flashes besides heat waves?
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When can hot flashes begin in women?
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What is the most effective treatment for vasomotor symptoms?
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What is a recommended lifestyle modification for reducing mild vasomotor symptoms?
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What is the effect of estrogen on the musculoskeletal system?
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What is osteoporosis defined as?
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What is the primary mechanism by which exercise improves cardiovascular health?
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What is the recommended frequency of exercise for obesity?
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What is the primary biological effect of exercise on bone?
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What is the primary mechanism of electrotherapy on bone?
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What is the recommended duration of electrotherapy for bone growth?
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What is the recommended intensity of exercise for cardiovascular health?
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What is the primary mechanism of exercise on depression?
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What type of exercise is recommended for osteoporosis?
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What is the primary goal of hormonal replacement therapy in menopausal women?
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What is a contraindication for hormonal therapy in menopausal women?
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What is the benefit of electrotherapy in menopausal women?
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What is the purpose of calcium intake in menopausal women?
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What is the role of exercises in menopausal women?
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What is the benefit of selective estrogen receptor modulators (SERMs) in menopausal women?
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What is the purpose of examination in menopausal women?
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What is a potential benefit of hormonal therapy in menopausal women?
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What is the definition of menopause?
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What is the primary difference between menopause and climacteric events?
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What is the name of the period that begins around 4 years before the last menstrual period (LMP)?
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What is the result of the decline in ovarian function during menopause?
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Why is it important to detect climacteric events?
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What is the definition of postmenopausal?
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What happens to fertility during perimenopause?
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What is the purpose of detecting and managing climacteric events?
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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.