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?

Declining ovarian function Signup and view all the answers

What is the effect of estrogen on cardiovascular circulation?

Protective effects on circulation and blood vessels Signup and view all the answers

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

Hot flashes and vasomotor changes Signup and view all the answers

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

Endometrial hyperplasia Signup and view all the answers

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

Decreased muscle tone and elasticity, leading to PFD Signup and view all the answers

What percentage of women are affected by vasomotor changes?

85% Signup and view all the answers

What is the duration of hot flashes?

1 minute to several minutes Signup and view all the answers

What is a symptom of hot flashes besides heat waves?

All of the above Signup and view all the answers

When can hot flashes begin in women?

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

What is the most effective treatment for vasomotor symptoms?

Hormonal therapy Signup and view all the answers

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

Dressing in layers Signup and view all the answers

What is the effect of estrogen on the musculoskeletal system?

Increases calcium absorption from the intestine Signup and view all the answers

What is osteoporosis defined as?

Low bone mineral density leading to compromised bone strength Signup and view all the answers

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

Increased endurance through aerobic exercises Signup and view all the answers

What is the recommended frequency of exercise for obesity?

Three times a week Signup and view all the answers

What is the primary biological effect of exercise on bone?

Increased osteoblastic activity Signup and view all the answers

What is the primary mechanism of electrotherapy on bone?

Piezoelectric effects Signup and view all the answers

What is the recommended duration of electrotherapy for bone growth?

1 hour a day Signup and view all the answers

What is the recommended intensity of exercise for cardiovascular health?

60% of VO2max Signup and view all the answers

What is the primary mechanism of exercise on depression?

Increased serotonin and norepinephrine levels in the brain Signup and view all the answers

What type of exercise is recommended for osteoporosis?

Weight-bearing exercises Signup and view all the answers

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

To relieve symptoms of menopause Signup and view all the answers

What is a contraindication for hormonal therapy in menopausal women?

Uncontrolled hypertension Signup and view all the answers

What is the benefit of electrotherapy in menopausal women?

Relief of symptoms Signup and view all the answers

What is the purpose of calcium intake in menopausal women?

To prevent osteoporosis Signup and view all the answers

What is the role of exercises in menopausal women?

To improve cardiovascular health Signup and view all the answers

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

Prevention of osteoporosis Signup and view all the answers

What is the purpose of examination in menopausal women?

To rule out underlying medical conditions Signup and view all the answers

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

Decreased risk of colonic cancer Signup and view all the answers

What is the definition of menopause?

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

What is the primary difference between menopause and climacteric events?

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

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

Perimenopause Signup and view all the answers

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

Follicular inactivity Signup and view all the answers

Why is it important to detect climacteric events?

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

What is the definition of postmenopausal?

The period after menopause. Signup and view all the answers

What happens to fertility during perimenopause?

It decreases Signup and view all the answers

What is the purpose of detecting and managing climacteric events?

To prevent the consequences of menopause. 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.