1
NU665D
NU665D/ NU 665D | Women's Health
Exam 1 | Qs & As| Grade A| 100%
Correct |(2025/ 2026 Update) Regis
Perimenopause - ANS ✓-transition phase between regular
menstrual periods and no periods at all
-Usually occurs ~40 ( dependent on multiple factors)
-Many menstrual irregularities around this time
-This time last 2-8 yrs, average 5
Risk factors for experiencing Menopause at an early age? - ANS ✓-
Smokers
-Type 1 DM
-Increased altitude
-Undernourished/ newly vegetarians
-Cancer treatment
-Hysterectomy
Treatment for : Perimenopause - ANS ✓-Catered towards
presenting symptoms
-Bleeding - after confirming bleeding is benign and from
hormonal instability: COC, POP, LNG-IUD, cycling progesterone,
cryoablation
NU665D
, 2
NU665D
-Vaginal atrophy - OTC lubricants, vaginal estrogen RX
-Mood irritability - antidepressants - SSRI (fluoxetine 10mg),
Effexor 37.5mg
-Menopausal symptoms - often relieved if you can stabilize
hormones. COC a good option. Gabapentin (neurontin) reduced
HF/NS
Perimenopause: Education - ANS ✓-Anticipatory guidance -
Should begin at age 40
-Vaginal dryness/Atrophy: Replens, Astroglide, KY jelly, lubrin,
Canola oil, Vit E 100-600/day, evening primrose oil 2-4
capsule/day
-Diet, Exercise for prevention of osteoporosis, Calcium 1000-
1200mg/day with 1000IU/day of Vit D
-Yearly mammogram and pelvic examination & BSE
-Need for contraception until 1 year of no menses
-Post menopausal bleeding and risks
-Prolapse- Kegels/pelvic floor PT
Menopause: Average age? - ANS ✓51 years old
Late menopause: >55
Hormone replacement therapy - ANS ✓-combined
estrogen/progesterone therapy that MUST be used in a woman
with an intact uterus
NU665D
, 3
NU665D
-Cyclic or Continuous treatment
Hormone replacement therapy: Indications? - ANS ✓-Bothersome
Vasomotor symptoms
-Prevention of bone loss ( remember lack of estrogen increases a
womens risk for osteoporosis)
-Hypoestrogenism caused by hypogonadism, castration, or POI
-Genitourinary symptoms
Hormone replacement therapy: Contraindications - ANS ✓-
Undiagnosed vaginal bleeding
-Known or suspected pregnancy
-Vascular thromboembolic episodes (CVA,MI, DVT,
Thrombophlebitis)
-Abrnormal mammogram ( Brst CA?)
-Active liver disease acute or chronic
-Known or suspected cancer of the breast or reproductive tract
Hormone replacement therapy: Precaution with these type of pt: -
ANS ✓-Type I DM
-Active gallbladder disease
-> 1ppd smoker
-Obesity
-FMH breast cancer
-Fibroid uterus
NU665D
NU665D
NU665D/ NU 665D | Women's Health
Exam 1 | Qs & As| Grade A| 100%
Correct |(2025/ 2026 Update) Regis
Perimenopause - ANS ✓-transition phase between regular
menstrual periods and no periods at all
-Usually occurs ~40 ( dependent on multiple factors)
-Many menstrual irregularities around this time
-This time last 2-8 yrs, average 5
Risk factors for experiencing Menopause at an early age? - ANS ✓-
Smokers
-Type 1 DM
-Increased altitude
-Undernourished/ newly vegetarians
-Cancer treatment
-Hysterectomy
Treatment for : Perimenopause - ANS ✓-Catered towards
presenting symptoms
-Bleeding - after confirming bleeding is benign and from
hormonal instability: COC, POP, LNG-IUD, cycling progesterone,
cryoablation
NU665D
, 2
NU665D
-Vaginal atrophy - OTC lubricants, vaginal estrogen RX
-Mood irritability - antidepressants - SSRI (fluoxetine 10mg),
Effexor 37.5mg
-Menopausal symptoms - often relieved if you can stabilize
hormones. COC a good option. Gabapentin (neurontin) reduced
HF/NS
Perimenopause: Education - ANS ✓-Anticipatory guidance -
Should begin at age 40
-Vaginal dryness/Atrophy: Replens, Astroglide, KY jelly, lubrin,
Canola oil, Vit E 100-600/day, evening primrose oil 2-4
capsule/day
-Diet, Exercise for prevention of osteoporosis, Calcium 1000-
1200mg/day with 1000IU/day of Vit D
-Yearly mammogram and pelvic examination & BSE
-Need for contraception until 1 year of no menses
-Post menopausal bleeding and risks
-Prolapse- Kegels/pelvic floor PT
Menopause: Average age? - ANS ✓51 years old
Late menopause: >55
Hormone replacement therapy - ANS ✓-combined
estrogen/progesterone therapy that MUST be used in a woman
with an intact uterus
NU665D
, 3
NU665D
-Cyclic or Continuous treatment
Hormone replacement therapy: Indications? - ANS ✓-Bothersome
Vasomotor symptoms
-Prevention of bone loss ( remember lack of estrogen increases a
womens risk for osteoporosis)
-Hypoestrogenism caused by hypogonadism, castration, or POI
-Genitourinary symptoms
Hormone replacement therapy: Contraindications - ANS ✓-
Undiagnosed vaginal bleeding
-Known or suspected pregnancy
-Vascular thromboembolic episodes (CVA,MI, DVT,
Thrombophlebitis)
-Abrnormal mammogram ( Brst CA?)
-Active liver disease acute or chronic
-Known or suspected cancer of the breast or reproductive tract
Hormone replacement therapy: Precaution with these type of pt: -
ANS ✓-Type I DM
-Active gallbladder disease
-> 1ppd smoker
-Obesity
-FMH breast cancer
-Fibroid uterus
NU665D
