NAMS MENOPAUSE ANSWERS AND QUESTIONS SET
A+
✔✔Bazedoxifene - ✔✔Selective Estrogen Receptor Modulator (SERM); vertebral
fracture risk reduced by 42% over 3 years; no effect on nonvertebral risk, no effect on
breast cancer risk proven; Combo of bazedoxifene 20 mg and .45 mg CEE daily
improves VMS and prevents bone loss in young postmenopausal women
✔✔Bisphosphonates - ✔✔Fosamax: inhibit bone resorption used in osteoporosis. AE:
dysphagia, esophageal ulcer. Nursing: take 1st thing in the morning w/o food, 8oz of
water, remain upright for 30mins after taking, if dose missed-skip
✔✔Fosamax (alendronate) - ✔✔Classification: Bone resorption inhibitor;
Bisphosphonate; Therapeutic Effects: TX and prevention of post-menopausal and
cortico-steroid-induced osteoporosis; Adverse Reactions & side effects: Altered taste,
photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis
✔✔Common upset stomach & heartburn - ✔✔GI effects Nursing Implications &
teaching: Take first thing in the AM, before eating anything; then pt MUST remain
upright for at least 30 mins! Take only with plain water. Monitor for GI side effects. Use
sunscreen to prevent photosensitivity reactions.
✔✔Risedronate (Actonel) - ✔✔Biphosphate. Taken daily, weekly, or monthly.
✔✔Zoledronic acid (Reclast, Zometa) - ✔✔Biphosphate. IV annually.
✔✔Denosumab - ✔✔Monoclonal antibody for postmenopausal women Subcutaneous
injection every 6 months.
✔✔salmon calcitonin - ✔✔Reduces bone loss in osteoporosis potent inhibitor of bone
resorption.
✔✔STI screening in <25 - ✔✔annual genital chlamydia and gonorrhea.
, ✔✔treatment for gonorrhea - ✔✔2021 guidelines: ceftriaxone 500 mg IM x1 or
ceftriaxone 1g IM x1 if > 150kg. If chlamydia not ruled out; doxy 100 BID 7 days.
✔✔when to repeat testing for Chlamydia? - ✔✔3 months.
✔✔Contraindications to HRT - ✔✔History of endometrial cancer, personal history of
breast cancer, history of thromboembolic disorders, acute or chronic liver disease,
coronary artery disease, elevated triglycerides, undiagnosed vaginal bleeding.
✔✔stage +2: late menopause stage - ✔✔5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
✔✔Stages +1a, +1b, +1c: early post menopause - ✔✔2 years after FMP. FSH rises,
estradiol decreases. VMS predominate.
✔✔When it is appropriate to check an FSH during the cycle - ✔✔Cycle day #3. Elevated
estradiol can suppress FSH giving a falsely normal FSH level.
✔✔Menopause transition-changes in SHBG and testosterone ratio? - ✔✔SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
✔✔Driving piece of menopause is ovarian follicles depleting. - ✔✔What does this do to
the inhibin B and AMH? Inhibin and AMH decrease.
✔✔Aldosterone - ✔✔Hormone regulating sodium and potassium balance.
✔✔Zona Reticularis - ✔✔Inner layer of adrenal cortex producing hormones.
✔✔Adrenocorticotropic Hormone (ACTH) - ✔✔Stimulates cortisol production from
adrenal glands.
✔✔Cortisol Binding Globulin - ✔✔Protein that transports cortisol in blood.
✔✔Oral Estrogen - ✔✔Increases cortisol binding globulin levels.
✔✔Transdermal Estrogen - ✔✔Minimal effect on serum cortisol concentration.
✔✔Vasopressin - ✔✔Hormone secreted by posterior pituitary gland.
✔✔Oligomenorrhea - ✔✔Irregular menstrual cycles with prolonged intervals.
✔✔Amenorrhea - ✔✔Absence of menstruation for at least 3 cycles.
A+
✔✔Bazedoxifene - ✔✔Selective Estrogen Receptor Modulator (SERM); vertebral
fracture risk reduced by 42% over 3 years; no effect on nonvertebral risk, no effect on
breast cancer risk proven; Combo of bazedoxifene 20 mg and .45 mg CEE daily
improves VMS and prevents bone loss in young postmenopausal women
✔✔Bisphosphonates - ✔✔Fosamax: inhibit bone resorption used in osteoporosis. AE:
dysphagia, esophageal ulcer. Nursing: take 1st thing in the morning w/o food, 8oz of
water, remain upright for 30mins after taking, if dose missed-skip
✔✔Fosamax (alendronate) - ✔✔Classification: Bone resorption inhibitor;
Bisphosphonate; Therapeutic Effects: TX and prevention of post-menopausal and
cortico-steroid-induced osteoporosis; Adverse Reactions & side effects: Altered taste,
photosensitivity, rash, musculoskeletal pain, fluid overload, esophagitis
✔✔Common upset stomach & heartburn - ✔✔GI effects Nursing Implications &
teaching: Take first thing in the AM, before eating anything; then pt MUST remain
upright for at least 30 mins! Take only with plain water. Monitor for GI side effects. Use
sunscreen to prevent photosensitivity reactions.
✔✔Risedronate (Actonel) - ✔✔Biphosphate. Taken daily, weekly, or monthly.
✔✔Zoledronic acid (Reclast, Zometa) - ✔✔Biphosphate. IV annually.
✔✔Denosumab - ✔✔Monoclonal antibody for postmenopausal women Subcutaneous
injection every 6 months.
✔✔salmon calcitonin - ✔✔Reduces bone loss in osteoporosis potent inhibitor of bone
resorption.
✔✔STI screening in <25 - ✔✔annual genital chlamydia and gonorrhea.
, ✔✔treatment for gonorrhea - ✔✔2021 guidelines: ceftriaxone 500 mg IM x1 or
ceftriaxone 1g IM x1 if > 150kg. If chlamydia not ruled out; doxy 100 BID 7 days.
✔✔when to repeat testing for Chlamydia? - ✔✔3 months.
✔✔Contraindications to HRT - ✔✔History of endometrial cancer, personal history of
breast cancer, history of thromboembolic disorders, acute or chronic liver disease,
coronary artery disease, elevated triglycerides, undiagnosed vaginal bleeding.
✔✔stage +2: late menopause stage - ✔✔5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
✔✔Stages +1a, +1b, +1c: early post menopause - ✔✔2 years after FMP. FSH rises,
estradiol decreases. VMS predominate.
✔✔When it is appropriate to check an FSH during the cycle - ✔✔Cycle day #3. Elevated
estradiol can suppress FSH giving a falsely normal FSH level.
✔✔Menopause transition-changes in SHBG and testosterone ratio? - ✔✔SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
✔✔Driving piece of menopause is ovarian follicles depleting. - ✔✔What does this do to
the inhibin B and AMH? Inhibin and AMH decrease.
✔✔Aldosterone - ✔✔Hormone regulating sodium and potassium balance.
✔✔Zona Reticularis - ✔✔Inner layer of adrenal cortex producing hormones.
✔✔Adrenocorticotropic Hormone (ACTH) - ✔✔Stimulates cortisol production from
adrenal glands.
✔✔Cortisol Binding Globulin - ✔✔Protein that transports cortisol in blood.
✔✔Oral Estrogen - ✔✔Increases cortisol binding globulin levels.
✔✔Transdermal Estrogen - ✔✔Minimal effect on serum cortisol concentration.
✔✔Vasopressin - ✔✔Hormone secreted by posterior pituitary gland.
✔✔Oligomenorrhea - ✔✔Irregular menstrual cycles with prolonged intervals.
✔✔Amenorrhea - ✔✔Absence of menstruation for at least 3 cycles.
