MENOPAUSE QUESTIONS AND ANSWERS
What is menopause? - Answers - point in time when loss of ovarian function is followed
by permanent cessation of menstruation
What is perimenopause? - Answers - Period of time immediately prior to and following
menopause
What is the climacteric period? - Answers - period of waning ovarian function when a
woman passes thru the transition from reproductive years into menopause
What is surgical menopause? - Answers - • Dramatic alterations within days of surgery
• manifestations much *more severe than natural menopause*
***** important to treat to minimize immediate symptoms and long term consequences
At what age is menopause? - Answers - • *Average age 51.5 years*
• Range of 48-55 years
What factors HASTEN menopause?? - Answers - • Smoking
• living at high altitudes
• malnutrition, thin habitus
• family tendency (mom was early so shall you be)
What DOES NOT affect menopause? - Answers - • Oral contraceptive use
• marital status
• parity
• race
• age at menarche
• socioeconomic status
• height
What is the Physiology of menopause? - Answers - • Fewer ovarian follicles cause rise
in FSH levels.
_ body really wants to ovulate so it amps up stimulation
• Increase in stromal component of ovary leads to shift in ratio from estrogen to
androgen
- more stroma= more androgens=more male hormone
How is estrogen produced AFTER menopause? - Answers - postmenopausal estrogen
production is a product of peripheral conversion of adrenal androstenedione (from
adrenal glands.
- occurs within body fat
- the more fat a person has the less S/S they should have
because they will make more estrogen
, How do you Dx menopause? - Answers - • *Testing usually unnecessary*
• day 2 or 3 serum FSH level >50 IU/ml
- only if still menstruating
• serum estradiol <50 pg/ml
• *amenorrhea for at least one year*
What is the DDx for menopause? - Answers - • Anxiety
• depression
• PMS
• thyroid disease
**need to r/o these before declaring menopause
What are the S/S of perimenopause? - Answers - 1. Irregular menstrual cycles
2. Sleep disturbances
3. Emotional imbalance
4. Vaginal changes
5. Vasomotor instability (hot flashes)
6. Joint pains
7. palpitations
8. short-term memory loss
9. mild thinning of scalp hair
10. mild hirsutism
11. urogenital symptoms
What are the changes to the menstruation encountered in menopause? - Answers - •
Varying length, interval, and amount of flow
• approximately 10% of cycles are ovulatory
• anovulatory (dysfunctional) uterine bleeding
• r/o bleeding from genital tract pathology
- cancer
- dysplasia
How do you evaluate abnormal vaginal bleeding?? - Answers - • Pelvic exam
• pap smear
• endometrial biopsy
• hysteroscopy, dilation & curettage
- if you get an abnormal test OR persistant bleeding with no
OTHER pathology
• pelvic ultrasound
What sleep disturbances can you see in menopausal women? - Answers - • Insomnia
• night sweats
• interrupted sleep pattern
What is menopause? - Answers - point in time when loss of ovarian function is followed
by permanent cessation of menstruation
What is perimenopause? - Answers - Period of time immediately prior to and following
menopause
What is the climacteric period? - Answers - period of waning ovarian function when a
woman passes thru the transition from reproductive years into menopause
What is surgical menopause? - Answers - • Dramatic alterations within days of surgery
• manifestations much *more severe than natural menopause*
***** important to treat to minimize immediate symptoms and long term consequences
At what age is menopause? - Answers - • *Average age 51.5 years*
• Range of 48-55 years
What factors HASTEN menopause?? - Answers - • Smoking
• living at high altitudes
• malnutrition, thin habitus
• family tendency (mom was early so shall you be)
What DOES NOT affect menopause? - Answers - • Oral contraceptive use
• marital status
• parity
• race
• age at menarche
• socioeconomic status
• height
What is the Physiology of menopause? - Answers - • Fewer ovarian follicles cause rise
in FSH levels.
_ body really wants to ovulate so it amps up stimulation
• Increase in stromal component of ovary leads to shift in ratio from estrogen to
androgen
- more stroma= more androgens=more male hormone
How is estrogen produced AFTER menopause? - Answers - postmenopausal estrogen
production is a product of peripheral conversion of adrenal androstenedione (from
adrenal glands.
- occurs within body fat
- the more fat a person has the less S/S they should have
because they will make more estrogen
, How do you Dx menopause? - Answers - • *Testing usually unnecessary*
• day 2 or 3 serum FSH level >50 IU/ml
- only if still menstruating
• serum estradiol <50 pg/ml
• *amenorrhea for at least one year*
What is the DDx for menopause? - Answers - • Anxiety
• depression
• PMS
• thyroid disease
**need to r/o these before declaring menopause
What are the S/S of perimenopause? - Answers - 1. Irregular menstrual cycles
2. Sleep disturbances
3. Emotional imbalance
4. Vaginal changes
5. Vasomotor instability (hot flashes)
6. Joint pains
7. palpitations
8. short-term memory loss
9. mild thinning of scalp hair
10. mild hirsutism
11. urogenital symptoms
What are the changes to the menstruation encountered in menopause? - Answers - •
Varying length, interval, and amount of flow
• approximately 10% of cycles are ovulatory
• anovulatory (dysfunctional) uterine bleeding
• r/o bleeding from genital tract pathology
- cancer
- dysplasia
How do you evaluate abnormal vaginal bleeding?? - Answers - • Pelvic exam
• pap smear
• endometrial biopsy
• hysteroscopy, dilation & curettage
- if you get an abnormal test OR persistant bleeding with no
OTHER pathology
• pelvic ultrasound
What sleep disturbances can you see in menopausal women? - Answers - • Insomnia
• night sweats
• interrupted sleep pattern
