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Questions and Answers

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?

  • 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?

  • Increased libido
  • Dyspareunia
  • Vaginal dryness
  • All of the above (correct)
  • What is the result of skin collagen loss during menopause?

    <p>Up to 30% loss of skin collagen in the first five years (B)</p> Signup and view all the answers

    What is a psychological change that may occur during menopause?

    <p>Irritability and anxiety (D)</p> Signup and view all the answers

    What therapy can prevent and reverse skin collagen loss during menopause?

    <p>Estrogen Replacement Therapy (A)</p> Signup and view all the answers

    What is the primary cause of permanent cessation of menstruation in menopause?

    <p>Failure of ovarian follicular development in the presence of adequate gonadotropins (B)</p> Signup and view all the answers

    What is the minimum duration of amenorrhea required for diagnosing menopause?

    <p>12 months (C)</p> Signup and view all the answers

    What is the term for the physiological period in a woman's life during which ovarian function regresses?

    <p>Climacteric (A)</p> Signup and view all the answers

    Which of the following hormones is relatively increased after menopause?

    <p>Testosterone (D)</p> Signup and view all the answers

    What is the most common and troublesome symptom for women at the climacteric?

    <p>Vasomotor instability (A)</p> Signup and view all the answers

    What is the effect of estrogen on cardiovascular disease?

    <p>It decreases the risk of cardiovascular disease (C)</p> Signup and view all the answers

    What is the pattern of hot flashes in women with advancing age?

    <p>They decrease in frequency and intensity (C)</p> Signup and view all the answers

    What is the characteristic pattern of menstrual changes in most women during the menopausal transition?

    <p>A gradual tapering in both amount and duration of flow (B)</p> Signup and view all the answers

    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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