Menopause
As a practicioner what is menopause an possibility for? - ANS-1. Establish an ongoing
relationship with patient
2. Patient training concerning menopause
three. Fitness screening (catch cancer)
four. Prevention and remedy
At what age is menopause? - ANS-• *Average age 51.Five years*
• Range of forty eight-fifty five years
How do you Dx menopause? - ANS-• *Testing usually needless*
• day 2 or 3 serum FSH level >50 IU/ml
- handiest if nevertheless menstruating
• serum estradiol <50 pg/ml
• *amenorrhea for as a minimum twelve months*
How do you compare peculiar vaginal bleeding?? - ANS-• Pelvic examination
• pap smear
• endometrial biopsy
• hysteroscopy, dilation & curettage
- in case you get an atypical check OR persistant bleeding and not using a
OTHER pathology
• pelvic ultrasound
How is estrogen produced AFTER menopause? - ANS-postmenopausal estrogen
manufacturing is a manufactured from peripheral conversion of adrenal androstenedione (from
adrenal glands.
- happens within body fat
- the more fats someone has the much less S/S they must have
because they may make greater estrogen
What are SERM's? - ANS-Selective estrogen receptor modulators
- work on special receptors at the identical time:
- AGONIST in bone estrogen receptor
- ANTAGONIST in breast/endometrial estrogen rcptr
- AGONIST in blood vessel estrogen rcpt.
• *Raloxifene*
- No increased danger of uterine cancer
- Decreased risk of breast most cancers
- No adverse impact of bleeding
- won't alleviate menopausal signs and symptoms
- May motive hot flushes
- Increases chance of stroke
What are some alternative to HRT that TREAT osteoporosis? - ANS-• Osteoporosis tx, *in
addition to prevention measures*:
, 1. Calcitonin
2. RhPTH (recombinant human parathyroid hormone)
- Teriparatide
What are some alternatives to HRT that cope with hot flashes? - ANS-*• SSRIs*
*• Soy protein*
• Black cohosh, other herbals
• Clonidine
• Progestins or androgens
• propranolol
What are a few options to HRT that address vaginal dryness? - ANS-• Topical estrogen cream
or capsules
• Nonprescription lubricants
- Astroglide
- KY
What are a few options to HRT that PREVENT osteoporosis? - ANS-*Osteoporosis Prevention*
1. Bisphosphonates
a. Alendronate (Fosamax) day by day or weekly
b. Risedronate (Actonel) daily or weekly
c. Ibandronate (Boniva) each day or monthly
2. Calcium 1200 mg/daily and Vitamin D four hundred-800 IU/every day
three. Selective estrogen receptor modulators (SERM)
What are some different types for HRT? - ANS-1. Oral drugs
2. Transdermal
3. Topical (no systemic influences)
- may be vaginal ring
What are some of the Tx for menopause S/S? - ANS-1. Correct calcium and vitamin D
deficiency
2. Weight-bearing exercise
three. Alendronate and calcitonin
four. Hormone replacement remedy (HRT)
5. Selective estrogen receptor modulators(SERMs)
What are the 3 important fitness problems related to guys-o-pause? - ANS-1. Osteoporosis
2. Cardiovascular sickness
3. Malignancy
* those all appear to be related to the lack of estrogen*
What are the ADVERSE affects of HRT? - ANS-*Think PMS*
• Breast tenderness
• Bloating
• Depression
• *Vaginal bleeding*
****If put up meopausal need w/o to r/o cancer
• Appetite alternate
• Insomnia
• Nausea
As a practicioner what is menopause an possibility for? - ANS-1. Establish an ongoing
relationship with patient
2. Patient training concerning menopause
three. Fitness screening (catch cancer)
four. Prevention and remedy
At what age is menopause? - ANS-• *Average age 51.Five years*
• Range of forty eight-fifty five years
How do you Dx menopause? - ANS-• *Testing usually needless*
• day 2 or 3 serum FSH level >50 IU/ml
- handiest if nevertheless menstruating
• serum estradiol <50 pg/ml
• *amenorrhea for as a minimum twelve months*
How do you compare peculiar vaginal bleeding?? - ANS-• Pelvic examination
• pap smear
• endometrial biopsy
• hysteroscopy, dilation & curettage
- in case you get an atypical check OR persistant bleeding and not using a
OTHER pathology
• pelvic ultrasound
How is estrogen produced AFTER menopause? - ANS-postmenopausal estrogen
manufacturing is a manufactured from peripheral conversion of adrenal androstenedione (from
adrenal glands.
- happens within body fat
- the more fats someone has the much less S/S they must have
because they may make greater estrogen
What are SERM's? - ANS-Selective estrogen receptor modulators
- work on special receptors at the identical time:
- AGONIST in bone estrogen receptor
- ANTAGONIST in breast/endometrial estrogen rcptr
- AGONIST in blood vessel estrogen rcpt.
• *Raloxifene*
- No increased danger of uterine cancer
- Decreased risk of breast most cancers
- No adverse impact of bleeding
- won't alleviate menopausal signs and symptoms
- May motive hot flushes
- Increases chance of stroke
What are some alternative to HRT that TREAT osteoporosis? - ANS-• Osteoporosis tx, *in
addition to prevention measures*:
, 1. Calcitonin
2. RhPTH (recombinant human parathyroid hormone)
- Teriparatide
What are some alternatives to HRT that cope with hot flashes? - ANS-*• SSRIs*
*• Soy protein*
• Black cohosh, other herbals
• Clonidine
• Progestins or androgens
• propranolol
What are a few options to HRT that address vaginal dryness? - ANS-• Topical estrogen cream
or capsules
• Nonprescription lubricants
- Astroglide
- KY
What are a few options to HRT that PREVENT osteoporosis? - ANS-*Osteoporosis Prevention*
1. Bisphosphonates
a. Alendronate (Fosamax) day by day or weekly
b. Risedronate (Actonel) daily or weekly
c. Ibandronate (Boniva) each day or monthly
2. Calcium 1200 mg/daily and Vitamin D four hundred-800 IU/every day
three. Selective estrogen receptor modulators (SERM)
What are some different types for HRT? - ANS-1. Oral drugs
2. Transdermal
3. Topical (no systemic influences)
- may be vaginal ring
What are some of the Tx for menopause S/S? - ANS-1. Correct calcium and vitamin D
deficiency
2. Weight-bearing exercise
three. Alendronate and calcitonin
four. Hormone replacement remedy (HRT)
5. Selective estrogen receptor modulators(SERMs)
What are the 3 important fitness problems related to guys-o-pause? - ANS-1. Osteoporosis
2. Cardiovascular sickness
3. Malignancy
* those all appear to be related to the lack of estrogen*
What are the ADVERSE affects of HRT? - ANS-*Think PMS*
• Breast tenderness
• Bloating
• Depression
• *Vaginal bleeding*
****If put up meopausal need w/o to r/o cancer
• Appetite alternate
• Insomnia
• Nausea
