Women's Health Exam III - Menopause
1. Menopause is described as a ______________
2. This happens when a woman reaches what ages?
3. What is menopause marked by?
4. Menopause is a time of menstrual and endocrine changes beginning ___________ - ANS1. a
natural decline in reproductive hormones
2. 40s - 50s
3. marked by the end of menses.
4. (below)
- variation in cycle length
- and ending with the final menstrual period
- (FMP is when 12 months of amenorrhea have passed after last menstrual period)
1. what kind of diagnosis is menopause?
2. how do you know if someone has gone through menopause?
3. what is the average age of menopause? - ANS1. a retrospective diagnosis
2. 12 months without any uterine bleeding
3. 40 - 58 years old, average age 51 years
What is periomenopause? - ANS- *symptomatic years of menopausal transition*
- time of endocrine and menstrual changes that start occurring for women in the years before
the final menstrual period
- encompassing the time from early menopausal transition to 12 months after final menstrual
period,
1. During perimenopause, what happens to estrogen levels?
2. How long does perimenopause last usually? - ANS1. During this time, estrogen levels
fluctuate, which can cause heavy, irregular periods and cramping.
2. 5 years
1. what happens to the number of follicles? - ANS- Number of follicles are rapidly diminishing
- with less follicles, the ovary is producing less of all the sex steroids (E, P, A)
- and so they are not there to give negative feedback to the HPO axis.
1. The ovaries before more resistant to FSH stimulation ___________ - ANS1. high peaking of
FSH
- With less follicles, the ovary is producing less off all the sex steroids (E,P,A)
- and so they are not there to give negative feedback to the HPO axis
- In response the pituitary puts out more and FSH and LH
1. Can we use hormone levels to diagnose menopause?
, 2. what are the hours to hour changes like? - ANS1. Although the hormones LH and FSH
(especially FSH) are trending upward in menopause
2. the actual levels hour to hour can be very erratic and that is why hormone testing for
menopause is considered to be very unreliable.
1. Once someone has gone fully through menopause (a year with no menses) what happens to
FSH?
2. So do guidelines suggest that FSH levels are tested for menopause? - ANS1. FSH tends to
be very high and stay forever at that peak level.
+ In the years leading up to transition, hormone levels are erratic.
2. Professional guidelines do not recommend testing hormones level to diagnosis menopause
(estrogen, FSH).
1. Should someone use contraception during periomenopause?
2. What if the person has a bilateral tubal ligation? - ANS1. Yes, just because you are not
ovulating at a regular schedule does not mean that you are not still ovulating.
2. Many patients have BTL, do not need BC.
1. It is difficult to determine if menopause if __________
2. a constant source of progestin does what to the body?
3. what do you do about concerns about masked postmenopausal bleeding?
4. __________ as an external source is protective against endometrial cancer. - ANS1. started
on birth control
2. Constant source of progestin is protective against endometrial cancer.
3. For concerns surrounding masked postmenopausal bleeding while a patient is on BC,
remember that Mirena (constant progestin) will be protective against endometrial cancer.
What are the STRAW guidelines? - ANS- guidelines for predicting when the onset of
menopause may be.
-5 -4 - 3 = reproductive stage
-2 -1 0 =(menopausal transition also perimenopasual)
0 +1 +2 = (postmenopausal)
Reproductive
-5 = early, -4 = peak -3 = late.
+ normal FSH
Menopausal transition -2 = early - 1 late
postmenopause +1 = early +2 = late
1. Menopause is described as a ______________
2. This happens when a woman reaches what ages?
3. What is menopause marked by?
4. Menopause is a time of menstrual and endocrine changes beginning ___________ - ANS1. a
natural decline in reproductive hormones
2. 40s - 50s
3. marked by the end of menses.
4. (below)
- variation in cycle length
- and ending with the final menstrual period
- (FMP is when 12 months of amenorrhea have passed after last menstrual period)
1. what kind of diagnosis is menopause?
2. how do you know if someone has gone through menopause?
3. what is the average age of menopause? - ANS1. a retrospective diagnosis
2. 12 months without any uterine bleeding
3. 40 - 58 years old, average age 51 years
What is periomenopause? - ANS- *symptomatic years of menopausal transition*
- time of endocrine and menstrual changes that start occurring for women in the years before
the final menstrual period
- encompassing the time from early menopausal transition to 12 months after final menstrual
period,
1. During perimenopause, what happens to estrogen levels?
2. How long does perimenopause last usually? - ANS1. During this time, estrogen levels
fluctuate, which can cause heavy, irregular periods and cramping.
2. 5 years
1. what happens to the number of follicles? - ANS- Number of follicles are rapidly diminishing
- with less follicles, the ovary is producing less of all the sex steroids (E, P, A)
- and so they are not there to give negative feedback to the HPO axis.
1. The ovaries before more resistant to FSH stimulation ___________ - ANS1. high peaking of
FSH
- With less follicles, the ovary is producing less off all the sex steroids (E,P,A)
- and so they are not there to give negative feedback to the HPO axis
- In response the pituitary puts out more and FSH and LH
1. Can we use hormone levels to diagnose menopause?
, 2. what are the hours to hour changes like? - ANS1. Although the hormones LH and FSH
(especially FSH) are trending upward in menopause
2. the actual levels hour to hour can be very erratic and that is why hormone testing for
menopause is considered to be very unreliable.
1. Once someone has gone fully through menopause (a year with no menses) what happens to
FSH?
2. So do guidelines suggest that FSH levels are tested for menopause? - ANS1. FSH tends to
be very high and stay forever at that peak level.
+ In the years leading up to transition, hormone levels are erratic.
2. Professional guidelines do not recommend testing hormones level to diagnosis menopause
(estrogen, FSH).
1. Should someone use contraception during periomenopause?
2. What if the person has a bilateral tubal ligation? - ANS1. Yes, just because you are not
ovulating at a regular schedule does not mean that you are not still ovulating.
2. Many patients have BTL, do not need BC.
1. It is difficult to determine if menopause if __________
2. a constant source of progestin does what to the body?
3. what do you do about concerns about masked postmenopausal bleeding?
4. __________ as an external source is protective against endometrial cancer. - ANS1. started
on birth control
2. Constant source of progestin is protective against endometrial cancer.
3. For concerns surrounding masked postmenopausal bleeding while a patient is on BC,
remember that Mirena (constant progestin) will be protective against endometrial cancer.
What are the STRAW guidelines? - ANS- guidelines for predicting when the onset of
menopause may be.
-5 -4 - 3 = reproductive stage
-2 -1 0 =(menopausal transition also perimenopasual)
0 +1 +2 = (postmenopausal)
Reproductive
-5 = early, -4 = peak -3 = late.
+ normal FSH
Menopausal transition -2 = early - 1 late
postmenopause +1 = early +2 = late
