Menopause Exam Prep: Women’s Health III Study Guide.
perimenopause/ menopause?
1. Define:
Perimenopause
4. Can we test FSH and LH to diagnose
menopause?
2. Define:
Menopause
3. What's
happening
hormonally
during
, Menopause Exam Prep: Women’s Health III Study Guide.
*The years leading up to RETROSPECTIVE diagnosis
menopause* - The accurate diagnosis occurs when a women has gone 12 months without
uterine bleeding. The average this happen in U.S. women is 51 years old, with the
- Refers to the time of normal range considered to be between 40 and 58 years of age
endocrine and menstrual
changes that start - The number of ovarian follicles is rapidly diminishing
occurring for women in the - The *ovaries become more resistant to FSH stimulation*
years before the final - With less follicles, the *ovary is producing less of all the sex steroids* (estrogen,
menstrual period. Varney progesterone, androgens), and so they are not there to give negative feedback to
cites 5 years as the the HPO axis. In response the pituitary puts out *more and FSH and LH*
average duration, with the - It is linear over all (like the graph makes it look) but on the day to day it is
range being 2-8 years. In fluctuating constantly
this time, women can start
to see variations in their
cycle length and begin to
experience the symptoms
of menopause (vasomotor, Nope.
vaginal, etc.).
- Varney states that Although the hormones LH and FSH (especially FSH) are trending upward in
menstrual changes can
start to occur 4-8 years
before final menses in
90% of women (common
is gradual decrease in
amount/days of
bleeding, others have
more erratic bleeding,
some have excess
bleeding)
*Full year of no bleeding*
- Menopause is a
, Menopause Exam Prep: Women’s Health III Study Guide.
menopause - the actual levels hour to hour can be very erratic and that is why
hormone testing for menopause is considered to be very unreliable
5. What happens to FSH tends to be very high and stay forever at that peak level
FSH when a
woman has ful-
ly gone through
menopause?
6. Do - Often times, yes
perimenopausal - Reduced but not absent fertility in the menopause transition. Varney sites a
women need study that up to 25% of cycles in the late reproductive years/early menopause are
birth control still? ovulatory. And we can't guess this based on age alone. That is why we have this
system called STRAW to try and assess the reproductive stage the woman is in
7. Let's say a OCPs if the patient needs birth control too, HRT if they don't
perimenopausal
We do not need a lot of hormone to control symptoms --> so while the low dose
woman is having
formulations we use to treat menopause symptoms are super ettective (in fact
hot flashes and
nothing is as ettective) they are not enough to prevent pregnancy
vaginal
symptoms.
When would we
use OCPs vs
HRT? How would
you explain this
to patients?
8. How does the HRT is only fraction of hormones that women have naturally before menopause,
level of hor- and much lower exposure to hormones than what is in birth control
mones in HRT
compare to the
levels females
produce be-
perimenopause/ menopause?
1. Define:
Perimenopause
4. Can we test FSH and LH to diagnose
menopause?
2. Define:
Menopause
3. What's
happening
hormonally
during
, Menopause Exam Prep: Women’s Health III Study Guide.
*The years leading up to RETROSPECTIVE diagnosis
menopause* - The accurate diagnosis occurs when a women has gone 12 months without
uterine bleeding. The average this happen in U.S. women is 51 years old, with the
- Refers to the time of normal range considered to be between 40 and 58 years of age
endocrine and menstrual
changes that start - The number of ovarian follicles is rapidly diminishing
occurring for women in the - The *ovaries become more resistant to FSH stimulation*
years before the final - With less follicles, the *ovary is producing less of all the sex steroids* (estrogen,
menstrual period. Varney progesterone, androgens), and so they are not there to give negative feedback to
cites 5 years as the the HPO axis. In response the pituitary puts out *more and FSH and LH*
average duration, with the - It is linear over all (like the graph makes it look) but on the day to day it is
range being 2-8 years. In fluctuating constantly
this time, women can start
to see variations in their
cycle length and begin to
experience the symptoms
of menopause (vasomotor, Nope.
vaginal, etc.).
- Varney states that Although the hormones LH and FSH (especially FSH) are trending upward in
menstrual changes can
start to occur 4-8 years
before final menses in
90% of women (common
is gradual decrease in
amount/days of
bleeding, others have
more erratic bleeding,
some have excess
bleeding)
*Full year of no bleeding*
- Menopause is a
, Menopause Exam Prep: Women’s Health III Study Guide.
menopause - the actual levels hour to hour can be very erratic and that is why
hormone testing for menopause is considered to be very unreliable
5. What happens to FSH tends to be very high and stay forever at that peak level
FSH when a
woman has ful-
ly gone through
menopause?
6. Do - Often times, yes
perimenopausal - Reduced but not absent fertility in the menopause transition. Varney sites a
women need study that up to 25% of cycles in the late reproductive years/early menopause are
birth control still? ovulatory. And we can't guess this based on age alone. That is why we have this
system called STRAW to try and assess the reproductive stage the woman is in
7. Let's say a OCPs if the patient needs birth control too, HRT if they don't
perimenopausal
We do not need a lot of hormone to control symptoms --> so while the low dose
woman is having
formulations we use to treat menopause symptoms are super ettective (in fact
hot flashes and
nothing is as ettective) they are not enough to prevent pregnancy
vaginal
symptoms.
When would we
use OCPs vs
HRT? How would
you explain this
to patients?
8. How does the HRT is only fraction of hormones that women have naturally before menopause,
level of hor- and much lower exposure to hormones than what is in birth control
mones in HRT
compare to the
levels females
produce be-
