Bank | Complete Questions & Answers
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‣ Climacteric phase The period of endrocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
‣ Early menopause LMP before age 45
‣ Late menopause LMP after age 54
‣ Primary ovarian insufficiency Menopause that occurs before age 40
‣ Early menopause transition (stage -2) Persistent difference of 7 days or
more in the length of consecutive cycles.
‣ Late menopause transition (stage -1) 60 or more consecutive days of
amenorrhea
‣ Luteal out of phase event (LOOP) Explains why some perimenopausal
women have elevated estrogen level sometimes...In the early menopause
transition, elevated FSH levels are adequate to recruit a second follicle
which results in a follicular phase-like rise in estradiol secretion
,superimposed on the mid-to-late luteal phase of the ongoing ovulatory
cycle.
‣ Obese women and estradiol levels during menopause Obese women
are more likely to have anovulatory cycles with high estradiol levels.
They are also more likely to have lower premenopause yet higher
postmenopause estradiol levels compared with women of normal weight.
(why they are at higher risk of endometrial cancer)
‣ Chinese and Japanese women These ethnic groups have lower estradiol
levels then white, black and hispanic women.
‣ 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.
‣ Elevated FSH, LH Endocrine labs after menopause
‣ AMH, inhibin B These hormones work during reproductive years to
not deplete follicle pool too quickly.
‣ Phases during menopause transition and PMS symptoms Menstrual
cycle shortenes, follicular phase compresses, women spend more time in
luteal phase.. meaning more premenstrual symptoms and more frequent
menstrual periods.
, ‣ How to respond if a patient requests FSH lab? many pitfalls, variable
depending on the day of the cycle you draw the lab, normal or low FSH
is not helpful.
‣ The potentially superior marker of menopause, a lab. AMH
‣ DHEA (dehydroepiandrosterone) Adrenal androgens: precursor
hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
‣ Location of estrogen receptors Vagina, vulva, urethra, trigone of the
bladder
‣ Effects of estrogen on tissue maintain blood flow, the collagen, and
HA within the epithelial surfaces. Supports microbiome and protects
tissue from pathogens.
‣ Vaginal changes with menopause Thinning, loss of elasticity, loss or
absence or rugae.
‣ Vagina and urethra in menopause vagina narrows, urethra moves
closer to the introitus.
‣ Stress urinary incontinence Vaginal estrogen and urinary incontinence:
what type does it help with?