Podcast
Questions and Answers
What happens to the vaginal walls after menopause?
What happens to the vaginal walls after menopause?
- They remain unchanged
- They become more elastic
- They become pale due to diminished vascularity (correct)
- They become thicker and more vascular
What is the primary function of lactobacilli in the vagina?
What is the primary function of lactobacilli in the vagina?
- To produce estrogen
- To metabolize glycogen and create an acidic pH (correct)
- To cause vaginitis
- To create an alkaline pH
What is a common symptom of genitourinary atrophy?
What is a common symptom of genitourinary atrophy?
- Increased libido
- Dyspareunia
- Vaginal dryness
- All of the above (correct)
What is the result of skin collagen loss during menopause?
What is the result of skin collagen loss during menopause?
What is a psychological change that may occur during menopause?
What is a psychological change that may occur during menopause?
What therapy can prevent and reverse skin collagen loss during menopause?
What therapy can prevent and reverse skin collagen loss during menopause?
What is the primary cause of permanent cessation of menstruation in menopause?
What is the primary cause of permanent cessation of menstruation in menopause?
What is the minimum duration of amenorrhea required for diagnosing menopause?
What is the minimum duration of amenorrhea required for diagnosing menopause?
What is the term for the physiological period in a woman's life during which ovarian function regresses?
What is the term for the physiological period in a woman's life during which ovarian function regresses?
Which of the following hormones is relatively increased after menopause?
Which of the following hormones is relatively increased after menopause?
What is the most common and troublesome symptom for women at the climacteric?
What is the most common and troublesome symptom for women at the climacteric?
What is the effect of estrogen on cardiovascular disease?
What is the effect of estrogen on cardiovascular disease?
What is the pattern of hot flashes in women with advancing age?
What is the pattern of hot flashes in women with advancing age?
What is the characteristic pattern of menstrual changes in most women during the menopausal transition?
What is the characteristic pattern of menstrual changes in most women during the menopausal transition?
Study Notes
Menopause and Climacteric
- Menopause is the permanent cessation of menstruation due to ovarian follicular development failure with adequate gonadotropins.
- Diagnosis of menopause is established when menstruation stops for 12 months in absence of an organic or pathological cause.
- Climacteric is the physiological period in a woman's life during which ovarian function regresses, spanning several years.
Stages of Menopause
- Pre-menopause
- Menopause
- Post-menopause
- Climacteric
Hormonal Changes after Menopause
- FSH and LH levels are elevated (>25 IU/L)
- Estrogen levels decrease
- Progesterone and inhibin levels decrease
- Testosterone levels are relatively increased
Clinical Changes
Menstrual Changes
- Most women experience a gradual tapering in 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 cardio-protective
- Estrogen increases HDL and decreases LDL
- Risk of cardiovascular disease increases after menopause
Genitourinary Atrophy
- Vaginal walls become pale and thin due to diminished vascularity
- Vaginal epithelial cells contain less glycogen, leading to increased risk of infection and ulceration
- 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
- 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)
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