NM701 Module 4 Menopause: Key Topics for Exam Success
Estrogen
Placebo
Venlafaxine (ettexor) -
SNRI's/SSRI's
Estrogen
LMP
NO hormone therapy + 12 full
months since LMP = the patient
can is in menopause and no
longer at risk for pregnancy.
1. Which interventions have solid evidence for im-
proving hot flashes in menopause? estrogen + progestin reduces
the risk of colorectal cancer
As long as smoking is the only
2. Which therapy works better than any other agent CV risk factor, adding estrogen
in reducing hot flashes in menopause? doesn't increase CVD enough
beyond smoking + age alone to
3. What is the best determinant of whether a midlife make estrogen contraindicated.
patient has reached menopause?
Note that this is only true for
menopausal doses of estrogen,
which are about 1/10 to 1/7 as
strong as those used for contra-
ception.
4. What is TRUE about hormone therapy for
menopause and cancer?
So smokers over 35 can use
5. What is important about the relationship between menopause-dosing of hormone
smoking and hormone therapy? therapy safely.
, NM701 Module 4 Menopause: Key Topics for Exam Success
6. When do clinicians need to consider osteoporosis Starts at menarche.
risk factors?
At risk: adolescents who do not
maintain enough body mass to
have periods are also not devel-
oping enough bone mass.
Dietary calcium intake & weight
bearing activity is important
7. What is true about sexuality and menopause? Dyspareunia can be resolved
with vaginal estrogen.
8. When does menopause begin? A transition that begins abut 7
years before the final period
9. Why is hormone testing a particularly poor way to Due to rapidly shifting HPO axis
diagnose or predict menopause? hormones. FSH, estrogen, and
LH can be markedly ditterent
from day to day during this time
AND for the year following the
final menstrual period
10. How does smoking affect menopause? Begins menopause about 2 yrs
earlier
11. Common sx of menopause? vasomotor sx (hot flashes/night
sweats) -80%
sleep problems
urogenital sx
12. A.FSH & LH Fluctuate during
perimenopause then rise over
, NM701 Module 4 Menopause: Key Topics for Exam Success
How do levels of the following hormones the 2 Fluctuate during peri-
change between the reproductive years and after menopause and rise over the 2
menopause? FSH LH Estrogens Testosterone years following the final period
and remain elevated
Estrogens
B.Estrogens
Less estradiol (potent estrogen)
with some estrone (less potent
estrogen, but still present)
Produced in reproductive age
1. Estradiol (E2): most potent
main estrogen, produced
by fetus during pregnancy
2. Estriol (E3): produced by pla-
centa
Menopause
1. Estrone (E1): weakest es-
trogen, primary in post-
menopausal women, children,
men
C.Testosterone Gradually de-
clines over time as a function of
aging, not bc of menopause
Presence of FSH & LH stimulate
the ovarian stromal tissues to in-
crease testosterone production;
hence facial hair
Estrogen
Placebo
Venlafaxine (ettexor) -
SNRI's/SSRI's
Estrogen
LMP
NO hormone therapy + 12 full
months since LMP = the patient
can is in menopause and no
longer at risk for pregnancy.
1. Which interventions have solid evidence for im-
proving hot flashes in menopause? estrogen + progestin reduces
the risk of colorectal cancer
As long as smoking is the only
2. Which therapy works better than any other agent CV risk factor, adding estrogen
in reducing hot flashes in menopause? doesn't increase CVD enough
beyond smoking + age alone to
3. What is the best determinant of whether a midlife make estrogen contraindicated.
patient has reached menopause?
Note that this is only true for
menopausal doses of estrogen,
which are about 1/10 to 1/7 as
strong as those used for contra-
ception.
4. What is TRUE about hormone therapy for
menopause and cancer?
So smokers over 35 can use
5. What is important about the relationship between menopause-dosing of hormone
smoking and hormone therapy? therapy safely.
, NM701 Module 4 Menopause: Key Topics for Exam Success
6. When do clinicians need to consider osteoporosis Starts at menarche.
risk factors?
At risk: adolescents who do not
maintain enough body mass to
have periods are also not devel-
oping enough bone mass.
Dietary calcium intake & weight
bearing activity is important
7. What is true about sexuality and menopause? Dyspareunia can be resolved
with vaginal estrogen.
8. When does menopause begin? A transition that begins abut 7
years before the final period
9. Why is hormone testing a particularly poor way to Due to rapidly shifting HPO axis
diagnose or predict menopause? hormones. FSH, estrogen, and
LH can be markedly ditterent
from day to day during this time
AND for the year following the
final menstrual period
10. How does smoking affect menopause? Begins menopause about 2 yrs
earlier
11. Common sx of menopause? vasomotor sx (hot flashes/night
sweats) -80%
sleep problems
urogenital sx
12. A.FSH & LH Fluctuate during
perimenopause then rise over
, NM701 Module 4 Menopause: Key Topics for Exam Success
How do levels of the following hormones the 2 Fluctuate during peri-
change between the reproductive years and after menopause and rise over the 2
menopause? FSH LH Estrogens Testosterone years following the final period
and remain elevated
Estrogens
B.Estrogens
Less estradiol (potent estrogen)
with some estrone (less potent
estrogen, but still present)
Produced in reproductive age
1. Estradiol (E2): most potent
main estrogen, produced
by fetus during pregnancy
2. Estriol (E3): produced by pla-
centa
Menopause
1. Estrone (E1): weakest es-
trogen, primary in post-
menopausal women, children,
men
C.Testosterone Gradually de-
clines over time as a function of
aging, not bc of menopause
Presence of FSH & LH stimulate
the ovarian stromal tissues to in-
crease testosterone production;
hence facial hair
