L49 Menopause
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The document discusses physiological and non-physiological menopause. Physiological menopause typically occurs between ages 51-52 and is diagnosed clinically based on symptoms. Tests are not useful during perimenopause due to hormonal variations. Non-physiological menopause can be premature before age 40, or iatrogenic due to medical treatments like chemotherapy or drugs that induce temporary menopause. Surgical menopause results from bilateral oophorectomy. Menopause affects women through vasomotor symptoms, psychological effects, changes to the endometrium and urogenital tract, impacts on bone health, and increased risk of conditions like dementia. Lifestyle and diet, pharmacological treatments, and hormonal replacement therapy
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Menopause management seminar
This document discusses menopause and management options. It begins by defining menopause as the permanent cessation of menstruation resulting from loss of ovarian activity, typically between ages 45-55. It then outlines some of the main consequences of menopause like vasomotor symptoms, sexual dysfunction, osteoporosis, and cardiovascular risks. The document discusses treatment options like lifestyle changes, hormone replacement therapy, and alternative therapies. It provides details on hormone replacement regimens and duration of treatment for various symptoms and conditions.
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The document discusses menopause and hormone replacement therapy. It defines menopause and describes the hormonal changes that occur during the menopausal transition as ovarian follicles are depleted and estrogen levels decline. This leads to symptoms like hot flashes, mood changes, and effects on the brain, skin and bones. Diagnosis of menopause is confirmed after 12 months of amenorrhea when FSH and estradiol levels indicate ovarian failure. Management of menopausal symptoms includes lifestyle changes, medications like estrogen therapy, and alternative therapies.
Menopause overview
Based on the information provided:
- The woman is 40 years old, which is below the typical age of menopause (around 50 years).
- She has not had any periods for 1 year.
To diagnose menopause in this woman:
1. I would do a beta human chorionic gonadotropin (hCG) test to rule out pregnancy.
2. I would check a follicle stimulating hormone (FSH) level. An FSH level over 35 mIU/ml would support the diagnosis of menopause.
3. I would do an ultrasound of the pelvis to examine the ovaries and rule out other potential causes of amenorrhea like polycystic
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This document discusses the management of menopause. It begins with a case study of a 51-year-old woman experiencing less frequent periods, hot flashes, and vaginal dryness. It then covers how to diagnose menopause, differential diagnoses, common menopause problems like hot flashes and sleep issues, and treatment approaches. Non-hormonal treatments discussed include lifestyle changes, but evidence for supplements is inconsistent. Hormonal therapy is recommended for relieving menopausal symptoms in most women, though risks must be considered.
Menopause and-physical-therapy-role-for-its-related-disorders (1)
Menopause and-physical-therapy-role-for-its-related-disorders (1)South Valley University, Egypt and Queen's University, Ontario
This document discusses menopause and physical therapy approaches for related disorders. It begins by defining menopause and related terms. It then describes the endocrinological changes associated with menopause and how this impacts various body systems. Common clinical features of menopause are outlined including vasomotor symptoms, neurological/psychological symptoms, and increased risk of osteoporosis and cardiovascular disease due to estrogen deficiency. The document concludes by describing various physical therapy approaches that can be used to treat postural problems, osteoporosis, pelvic floor dysfunction, and other menopause-related conditions. Modalities discussed include resistance training, aerobic exercise, pulsed electromagnetic field therapy, and low-level laser therapyAmenorrhoea
Amenorrhoea is the absence of menstrual periods in a woman of reproductive age. There are two main types: primary amenorrhoea, where periods do not start by age 16, and secondary amenorrhoea, where established periods stop for six months or more. Common causes of secondary amenorrhoea include pregnancy, breastfeeding, contraceptive use, stress, weight change, excessive exercise, and medical conditions affecting hormone levels like polycystic ovary syndrome. Treatment depends on the underlying cause but may involve lifestyle changes, hormone therapy, weight management, or fertility treatment.
Harmone replacement therapy
This document discusses hormonal replacement therapy (HRT). It begins by defining HRT as any medical treatment that replaces hormones the body can no longer produce on its own due to age or organ damage/failure. The main types of HRT are then listed, including various sex hormones. Effects of HRT for transgender individuals and testosterone replacement therapy are also outlined. The document concludes by discussing menopause, including its phases, causes, and physiological changes like hormonal and ovarian changes.
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This document discusses menopause and management options. It begins by defining menopause as the permanent cessation of menstruation resulting from loss of ovarian activity, typically between ages 45-55. It then outlines some of the main consequences of menopause like vasomotor symptoms, sexual dysfunction, osteoporosis, and cardiovascular risks. The document discusses treatment options like lifestyle changes, hormone replacement therapy, and alternative therapies. It provides details on hormone replacement regimens and duration of treatment for various symptoms and conditions.
Management of menopause
A presentation about the diagnosis and treatment of menopause from the family medicine program at HMC-Qatar.
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The document discusses menopause and hormone replacement therapy. It defines menopause and describes the hormonal changes that occur during the menopausal transition as ovarian follicles are depleted and estrogen levels decline. This leads to symptoms like hot flashes, mood changes, and effects on the brain, skin and bones. Diagnosis of menopause is confirmed after 12 months of amenorrhea when FSH and estradiol levels indicate ovarian failure. Management of menopausal symptoms includes lifestyle changes, medications like estrogen therapy, and alternative therapies.
Menopause overview
Based on the information provided:
- The woman is 40 years old, which is below the typical age of menopause (around 50 years).
- She has not had any periods for 1 year.
To diagnose menopause in this woman:
1. I would do a beta human chorionic gonadotropin (hCG) test to rule out pregnancy.
2. I would check a follicle stimulating hormone (FSH) level. An FSH level over 35 mIU/ml would support the diagnosis of menopause.
3. I would do an ultrasound of the pelvis to examine the ovaries and rule out other potential causes of amenorrhea like polycystic
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This document discusses the management of menopause. It begins with a case study of a 51-year-old woman experiencing less frequent periods, hot flashes, and vaginal dryness. It then covers how to diagnose menopause, differential diagnoses, common menopause problems like hot flashes and sleep issues, and treatment approaches. Non-hormonal treatments discussed include lifestyle changes, but evidence for supplements is inconsistent. Hormonal therapy is recommended for relieving menopausal symptoms in most women, though risks must be considered.
Menopause and-physical-therapy-role-for-its-related-disorders (1)
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This document discusses menopause and physical therapy approaches for related disorders. It begins by defining menopause and related terms. It then describes the endocrinological changes associated with menopause and how this impacts various body systems. Common clinical features of menopause are outlined including vasomotor symptoms, neurological/psychological symptoms, and increased risk of osteoporosis and cardiovascular disease due to estrogen deficiency. The document concludes by describing various physical therapy approaches that can be used to treat postural problems, osteoporosis, pelvic floor dysfunction, and other menopause-related conditions. Modalities discussed include resistance training, aerobic exercise, pulsed electromagnetic field therapy, and low-level laser therapyAmenorrhoea
Amenorrhoea is the absence of menstrual periods in a woman of reproductive age. There are two main types: primary amenorrhoea, where periods do not start by age 16, and secondary amenorrhoea, where established periods stop for six months or more. Common causes of secondary amenorrhoea include pregnancy, breastfeeding, contraceptive use, stress, weight change, excessive exercise, and medical conditions affecting hormone levels like polycystic ovary syndrome. Treatment depends on the underlying cause but may involve lifestyle changes, hormone therapy, weight management, or fertility treatment.
Harmone replacement therapy
This document discusses hormonal replacement therapy (HRT). It begins by defining HRT as any medical treatment that replaces hormones the body can no longer produce on its own due to age or organ damage/failure. The main types of HRT are then listed, including various sex hormones. Effects of HRT for transgender individuals and testosterone replacement therapy are also outlined. The document concludes by discussing menopause, including its phases, causes, and physiological changes like hormonal and ovarian changes.
Climacteric_Physiology[1].pptx
The document discusses the physiology of menopause and andropause. It describes how menopause is defined as the permanent cessation of menstruation after 12 months without any other pathology, usually occurring between ages 45-55. It outlines the hormonal changes that occur during perimenopause and menopause, including declining estrogen, progesterone, and rising FSH and LH levels. Symptoms result from these hormonal alterations. Treatment options and the physiology of the male equivalent, andropause, are also reviewed.
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This document provides information on menopause and related topics. It discusses:
- The definition and causes of menopause, including natural menopause and premature menopause.
- Short, intermediate, and long term effects of menopause on a woman's health, including risks of osteoporosis, cardiovascular disease, and other conditions.
- Diagnosis of menopause and premature ovarian failure.
- Treatment options for menopausal symptoms including hormone replacement therapy and other medications, as well as their risks and benefits.
- Alternative and complementary therapies that can be used to treat menopausal symptoms.
Menopause
Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovaries stop producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year.
Menopause
1. Menopause is the permanent cessation of menstruation and fertility that occurs naturally in women around the age of 50, on average.
2. It is diagnosed after 12 consecutive months of amenorrhea without any other pathological cause.
3. The stages of menopause include premenopause, perimenopause, menopause, and postmenopause, with various physiological and psychological changes occurring in each phase.
Women's Disorders-Revised.ppt
The document discusses various women's reproductive disorders and the menstrual cycle. It describes the internal female genital organs and the two phases of the menstrual cycle. It then discusses menstrual disorders like amenorrhea, dysfunctional uterine bleeding, and dysmenorrhea. It provides information on the causes and treatments of these disorders. The document also covers other topics related to women's health issues like infertility, early pregnancy loss, menopause, and premenstrual syndrome.
Menopause
The document discusses menopause, defining it as occurring after 12 months of amenorrhea and summarizing the stages of reproductive aging. It notes that menopause is caused by the programmed loss of ovarian follicles and describes changes in hormones like FSH and estradiol during the menopausal transition. Some key points covered include that the average age of menopause is 51.4 years, symptoms include hot flashes and vaginal dryness, and common therapies involve estrogen supplementation or behavioral changes.
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Menopause
Menopause is defined as the absence of menstrual periods for 12 months and marks the end of a woman's reproductive years. It is caused by a natural decline in ovarian function with age. The average age of menopause is 51 but it can occur earlier or later. Perimenopause is the transition period before menopause where estrogen levels fluctuate. Hormone replacement therapy can be used to treat menopause symptoms but requires evaluation for safety.
Menopause
This document discusses menopause and related topics. It defines menopause as the permanent cessation of menstruation resulting from loss of ovarian activity. Natural menopause is recognized after 12 months of amenorrhea without other causes. Women in the UK typically experience menopause between ages 45-55. The document also discusses premenopause, perimenopause, postmenopause, premature ovarian insufficiency, symptoms, diagnosis, and management including hormone replacement therapy.
menopause.pptxfor bscnursing students pdf.
This document discusses menopause and provides definitions and details related to the cessation of menstruation and ovarian function. It defines natural menopause as occurring after 12 consecutive months of amenorrhea for women around 47 years old on average. Premature menopause is defined as occurring before age 40. The document also discusses the hormonal changes, symptoms, risks, diagnosis, and treatment options associated with menopause such as hormone replacement therapy.
Menopause & hormonal replacement therapy
Menopause is defined as the final menstrual period and results from loss of ovarian function. It occurs on average between ages 50-51 and can be influenced by various factors like smoking or surgery. Symptoms include hot flashes, sleep changes, mood changes and vaginal dryness. Hormone levels fluctuate during the menopausal transition and estrogen levels dramatically decline after menopause. Diagnosis is made after 12 months of no periods and confirmed by elevated FSH levels. Treatment options aim to relieve symptoms and prevent bone loss and include hormone therapy and non-hormonal therapies like SSRIs. HRT carries some health risks but may help vasomotor symptoms and prevent osteoporosis when used at lowest effective
hormonal replacement therapy.pptx
This document discusses menopause and hormonal replacement therapy. It begins by defining menopause and describing the stages and symptoms. It then discusses the diagnosis of menopause and various treatment options for managing symptoms, including lifestyle changes, supplements, medications, and hormone replacement therapy. HRT can help relieve symptoms but also carries some health risks, so the document outlines the appropriate usage and monitoring of HRT.
Menopause-1.pptx
This document defines menopause and discusses its causes, types, endocrine changes, symptoms, and management. Menopause is defined as the final menstrual period confirmed after 1 year of amenorrhea, caused by cessation of ovarian function. It can be physiological after around age 51-52, or non-physiological before age 40. Hormonal changes include declines in estrogen, progesterone, and other hormones. Symptoms affect the cardiovascular, genitourinary, neurological, skeletal, and other systems. Management includes lifestyle changes and hormone replacement therapy, which has contraindications and potential side effects.
Hormone replacement therapy (HRT)
This document discusses menopause and hormone replacement therapy (HRT). It defines different types of menopause and explains the role of estrogen and progesterone in the body. Symptoms of estrogen and progesterone deficiency are outlined. The document discusses the indications, benefits, and risks of HRT for osteoporosis and cardiovascular health. Contraindications to HRT include a history of certain cancers, liver disease, or blood clots. Proper counseling, screening, and the shortest effective treatment duration are recommended for HRT.
Menopause.pptx
Menopause typically occurs between ages 50-52 as ovaries stop producing eggs and estrogen levels decline. Symptoms include hot flashes, night sweats, and vaginal dryness. Management includes lifestyle changes and various hormonal and non-hormonal treatments to relieve symptoms and prevent long-term issues like osteoporosis and heart disease. Hormone replacement therapy (HRT) effectively treats short-term menopausal issues but carries risks if used long-term like an increased risk of breast cancer. Careful screening and use of the lowest effective dose for the shortest time is recommended for HRT.
hormonal replacement therapy
1. The document summarizes two patient cases involving menopause and hormone replacement therapy (HRT). The first case is a 52-year-old woman experiencing menopausal symptoms who is continuing HRT. The second case is a 51-year-old woman with Sheehan's syndrome who is being weaned off HRT.
2. The document then reviews recommendations and guidelines for HRT use, including that it remains the most effective treatment for vasomotor symptoms. It discusses the immediate effects of HRT on various systems and considerations for progestogen use.
3. Alternative treatments to HRT are also mentioned, including SSRIs, venlafaxine, and phytoestrog
management of menopause cpg.pptx
The document provides guidelines for the management of menopause. It defines menopause and outlines the stages of menopause including perimenopause. It discusses various symptoms of menopause like vasomotor symptoms, genitourinary syndrome of menopause, and mood symptoms. It also covers the effects and complications of menopause including increased risk of cardiovascular disease, osteoporosis, and cognitive decline. The guidelines recommend menopausal hormonal therapy for treatment of symptoms in most women, and discuss various treatment options including different routes of administration and combinations of estrogen and progesterone. Risks and benefits of therapy are weighed based on factors like age and time since menopause.
Menopause by roel tolentino
Menopause is a natural physiological process marked by the loss of ovarian function and fertility. It typically occurs between ages 48-52 and can cause various symptoms due to declining estrogen levels. Long term effects include increased risk of cardiovascular disease and osteoporosis. While hormone therapy can provide relief from symptoms, it may also increase risks for some cancers and other conditions. Careful evaluation and treatment of symptoms is important for women's health and quality of life during this transition.
Menopause
Menopause is defined as the permanent cessation of menstruation due to loss of ovarian activity, occurring typically between ages 45-55. It marks the end of a woman's reproductive life and is a natural part of aging. Common symptoms include hot flashes, night sweats, sleep problems, mood changes, and vaginal dryness due to declining estrogen levels. Hormone replacement therapy can help treat short-term symptoms but carries some health risks with long-term use. Lifestyle changes and supplements are generally recommended first before considering hormone therapy.
Contraversies of hrt!.pptx
This document provides an overview of controversies surrounding hormonal replacement therapy (HRT) and menopausal hormone therapy (MHT). It discusses the history of HRT, how the paradigm has shifted from viewing it as a preventative treatment to one focused on symptom relief. Key topics covered include the indications, contraindications and effects of HRT on breast cancer, endometrial cancer, osteoporosis and fractures. Routes of administration and precautions for prescribing HRT are also summarized.
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Climacteric_Physiology[1].pptx
The document discusses the physiology of menopause and andropause. It describes how menopause is defined as the permanent cessation of menstruation after 12 months without any other pathology, usually occurring between ages 45-55. It outlines the hormonal changes that occur during perimenopause and menopause, including declining estrogen, progesterone, and rising FSH and LH levels. Symptoms result from these hormonal alterations. Treatment options and the physiology of the male equivalent, andropause, are also reviewed.
Menopaus1
This document provides information on menopause and related topics. It discusses:
- The definition and causes of menopause, including natural menopause and premature menopause.
- Short, intermediate, and long term effects of menopause on a woman's health, including risks of osteoporosis, cardiovascular disease, and other conditions.
- Diagnosis of menopause and premature ovarian failure.
- Treatment options for menopausal symptoms including hormone replacement therapy and other medications, as well as their risks and benefits.
- Alternative and complementary therapies that can be used to treat menopausal symptoms.
Menopause
Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovaries stop producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year.
Menopause
1. Menopause is the permanent cessation of menstruation and fertility that occurs naturally in women around the age of 50, on average.
2. It is diagnosed after 12 consecutive months of amenorrhea without any other pathological cause.
3. The stages of menopause include premenopause, perimenopause, menopause, and postmenopause, with various physiological and psychological changes occurring in each phase.
Women's Disorders-Revised.ppt
The document discusses various women's reproductive disorders and the menstrual cycle. It describes the internal female genital organs and the two phases of the menstrual cycle. It then discusses menstrual disorders like amenorrhea, dysfunctional uterine bleeding, and dysmenorrhea. It provides information on the causes and treatments of these disorders. The document also covers other topics related to women's health issues like infertility, early pregnancy loss, menopause, and premenstrual syndrome.
Menopause
The document discusses menopause, defining it as occurring after 12 months of amenorrhea and summarizing the stages of reproductive aging. It notes that menopause is caused by the programmed loss of ovarian follicles and describes changes in hormones like FSH and estradiol during the menopausal transition. Some key points covered include that the average age of menopause is 51.4 years, symptoms include hot flashes and vaginal dryness, and common therapies involve estrogen supplementation or behavioral changes.
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This document discusses several reproductive disorders in women including menopause, premenstrual syndrome, dysmenorrhea, amenorrhea, menorrhagia, metrorrhagia, abortion, spontaneous abortion, and habitual abortion. It describes the symptoms, causes, medical management, and nursing care considerations for each condition. Key points covered include the hormonal changes that occur during menopause and how it is signaled, common symptoms of premenstrual syndrome, painful menstruation associated with dysmenorrhea, and definitions and types of abortion.
Menopause
Menopause is defined as the absence of menstrual periods for 12 months and marks the end of a woman's reproductive years. It is caused by a natural decline in ovarian function with age. The average age of menopause is 51 but it can occur earlier or later. Perimenopause is the transition period before menopause where estrogen levels fluctuate. Hormone replacement therapy can be used to treat menopause symptoms but requires evaluation for safety.
Menopause
This document discusses menopause and related topics. It defines menopause as the permanent cessation of menstruation resulting from loss of ovarian activity. Natural menopause is recognized after 12 months of amenorrhea without other causes. Women in the UK typically experience menopause between ages 45-55. The document also discusses premenopause, perimenopause, postmenopause, premature ovarian insufficiency, symptoms, diagnosis, and management including hormone replacement therapy.
menopause.pptxfor bscnursing students pdf.
This document discusses menopause and provides definitions and details related to the cessation of menstruation and ovarian function. It defines natural menopause as occurring after 12 consecutive months of amenorrhea for women around 47 years old on average. Premature menopause is defined as occurring before age 40. The document also discusses the hormonal changes, symptoms, risks, diagnosis, and treatment options associated with menopause such as hormone replacement therapy.
Menopause & hormonal replacement therapy
Menopause is defined as the final menstrual period and results from loss of ovarian function. It occurs on average between ages 50-51 and can be influenced by various factors like smoking or surgery. Symptoms include hot flashes, sleep changes, mood changes and vaginal dryness. Hormone levels fluctuate during the menopausal transition and estrogen levels dramatically decline after menopause. Diagnosis is made after 12 months of no periods and confirmed by elevated FSH levels. Treatment options aim to relieve symptoms and prevent bone loss and include hormone therapy and non-hormonal therapies like SSRIs. HRT carries some health risks but may help vasomotor symptoms and prevent osteoporosis when used at lowest effective
hormonal replacement therapy.pptx
This document discusses menopause and hormonal replacement therapy. It begins by defining menopause and describing the stages and symptoms. It then discusses the diagnosis of menopause and various treatment options for managing symptoms, including lifestyle changes, supplements, medications, and hormone replacement therapy. HRT can help relieve symptoms but also carries some health risks, so the document outlines the appropriate usage and monitoring of HRT.
Menopause-1.pptx
This document defines menopause and discusses its causes, types, endocrine changes, symptoms, and management. Menopause is defined as the final menstrual period confirmed after 1 year of amenorrhea, caused by cessation of ovarian function. It can be physiological after around age 51-52, or non-physiological before age 40. Hormonal changes include declines in estrogen, progesterone, and other hormones. Symptoms affect the cardiovascular, genitourinary, neurological, skeletal, and other systems. Management includes lifestyle changes and hormone replacement therapy, which has contraindications and potential side effects.
Hormone replacement therapy (HRT)
This document discusses menopause and hormone replacement therapy (HRT). It defines different types of menopause and explains the role of estrogen and progesterone in the body. Symptoms of estrogen and progesterone deficiency are outlined. The document discusses the indications, benefits, and risks of HRT for osteoporosis and cardiovascular health. Contraindications to HRT include a history of certain cancers, liver disease, or blood clots. Proper counseling, screening, and the shortest effective treatment duration are recommended for HRT.
Menopause.pptx
Menopause typically occurs between ages 50-52 as ovaries stop producing eggs and estrogen levels decline. Symptoms include hot flashes, night sweats, and vaginal dryness. Management includes lifestyle changes and various hormonal and non-hormonal treatments to relieve symptoms and prevent long-term issues like osteoporosis and heart disease. Hormone replacement therapy (HRT) effectively treats short-term menopausal issues but carries risks if used long-term like an increased risk of breast cancer. Careful screening and use of the lowest effective dose for the shortest time is recommended for HRT.
hormonal replacement therapy
1. The document summarizes two patient cases involving menopause and hormone replacement therapy (HRT). The first case is a 52-year-old woman experiencing menopausal symptoms who is continuing HRT. The second case is a 51-year-old woman with Sheehan's syndrome who is being weaned off HRT.
2. The document then reviews recommendations and guidelines for HRT use, including that it remains the most effective treatment for vasomotor symptoms. It discusses the immediate effects of HRT on various systems and considerations for progestogen use.
3. Alternative treatments to HRT are also mentioned, including SSRIs, venlafaxine, and phytoestrog
management of menopause cpg.pptx
The document provides guidelines for the management of menopause. It defines menopause and outlines the stages of menopause including perimenopause. It discusses various symptoms of menopause like vasomotor symptoms, genitourinary syndrome of menopause, and mood symptoms. It also covers the effects and complications of menopause including increased risk of cardiovascular disease, osteoporosis, and cognitive decline. The guidelines recommend menopausal hormonal therapy for treatment of symptoms in most women, and discuss various treatment options including different routes of administration and combinations of estrogen and progesterone. Risks and benefits of therapy are weighed based on factors like age and time since menopause.
Menopause by roel tolentino
Menopause is a natural physiological process marked by the loss of ovarian function and fertility. It typically occurs between ages 48-52 and can cause various symptoms due to declining estrogen levels. Long term effects include increased risk of cardiovascular disease and osteoporosis. While hormone therapy can provide relief from symptoms, it may also increase risks for some cancers and other conditions. Careful evaluation and treatment of symptoms is important for women's health and quality of life during this transition.
Menopause
Menopause is defined as the permanent cessation of menstruation due to loss of ovarian activity, occurring typically between ages 45-55. It marks the end of a woman's reproductive life and is a natural part of aging. Common symptoms include hot flashes, night sweats, sleep problems, mood changes, and vaginal dryness due to declining estrogen levels. Hormone replacement therapy can help treat short-term symptoms but carries some health risks with long-term use. Lifestyle changes and supplements are generally recommended first before considering hormone therapy.
Contraversies of hrt!.pptx
This document provides an overview of controversies surrounding hormonal replacement therapy (HRT) and menopausal hormone therapy (MHT). It discusses the history of HRT, how the paradigm has shifted from viewing it as a preventative treatment to one focused on symptom relief. Key topics covered include the indications, contraindications and effects of HRT on breast cancer, endometrial cancer, osteoporosis and fractures. Routes of administration and precautions for prescribing HRT are also summarized.
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Urinary incontinence is the involuntary passage of urine. It has many potential causes, including medical conditions, medications, pregnancy, and pelvic muscle weakness. There are several types of incontinence including urge, stress, mixed, overflow, and functional. Treatment options include behavioral techniques like pelvic floor exercises, pharmacologic options like anticholinergic medications, and surgical procedures for stress incontinence like mid-urethral tapes or Burch colposuspension. Evaluation involves patient history, exam, testing for post-void residual volume, and sometimes urodynamic studies.
L39 Gynecological infections & ulcers
This document discusses common gynecological infections and their assessment and treatment. Bacterial vaginosis, caused by overgrowth of anaerobic bacteria and reduction of lactobacillus, is the most common abnormal vaginal discharge. Candida albicans can cause pruritis and curdy discharge. Trichomoniasis presents with foul smelling discharge and causes dysuria. Genital ulcers may be caused by HSV, syphilis, chancroid, or lymphogranuloma venereum. Neisseria gonorrhoeae and Chlamydia trachomatis are sexually transmitted infections that can cause vaginitis, cervicitis, or asymptomatic infection. Diagnosis involves
L38 Abnormal uterine bleeding
This document discusses abnormal uterine bleeding, which includes heavy menstrual bleeding and irregular bleeding. It defines normal menstrual cycles and what constitutes abnormal bleeding. The main types of abnormal uterine bleeding are defined. Heavy menstrual bleeding is elaborated on and its causes and investigations are outlined. Medical and surgical treatment options for abnormal uterine bleeding are summarized. Postmenopausal bleeding is also addressed.
L37 POLYCYSTIC OVARY SYNDROME
The document discusses polycystic ovary syndrome (PCOS), including its diagnosis using the Rotterdam criteria of oligo-/anovulation, hyperandrogenism, and polycystic ovaries on ultrasound. PCOS is caused by altered GnRH pulsatility leading to increased LH levels and insulin resistance causing hyperandrogenemia and anovulation. Management focuses on treating menstrual irregularity, hyperandrogenism, and complications like infertility, glucose intolerance, endometrial cancer risk, and cardiovascular disease risk.
L36 Premenstrual syndrome
Premenstrual syndrome is a condition where women experience physical and psychological symptoms cyclically before menstruation that impact quality of life. Common psychological symptoms include depression, irritability, and anxiety while physical symptoms are bloatedness and breast tenderness. It may be caused by sensitivity to progesterone levels and low activity of the neurotransmitter GABA. Diagnosis involves keeping a symptom diary for two cycles and sometimes a 3-month GnRH analogues test if the diary is inconclusive.
L35 Endometriosis
Endometriosis is an estrogen-dependent disease where endometrial tissue grows outside the uterus, most commonly on the pelvic peritoneum and ovaries. It affects 5-10% of women and is a common cause of pelvic pain and infertility. While the exact cause is unknown, theories include retrograde menstruation through the fallopian tubes and genetic or immunological factors. Diagnosis involves laparoscopy to visualize lesions, and ultrasound or MRI may also help. Treatment depends on symptoms but may include pain medications, hormonal therapy, or surgery to remove growths or the ovaries/uterus. Surgical treatment can help fertility in mild-moderate cases.
L34 Operative delivery
Operative vaginal deliveries using vacuum extraction or forceps can be used when there are indications for expedited delivery such as prolonged second stage of labor, fetal distress, or maternal medical complications. Vacuum extraction uses suction cups applied to the fetal head while forceps provide traction, elevation, and rotation. Both have risks of maternal and neonatal injuries. Cesarean section is indicated when vaginal delivery would put the mother or baby at risk, such as cephalopelvic disproportion or non-reassuring fetal status. While cesarean reduces some risks, it also carries increased risks of infection, thrombosis, and longer recovery for the mother.
L33 Induction of labor
Induction of labor refers to stimulating uterine contractions before spontaneous labor to achieve vaginal delivery, while augmentation increases existing contractions for labor progress. Indications for induction include prolonged pregnancy, PROM, hypertension, FGR, diabetes, macrosomia, maternal illness, hemorrhage, or twins over 38 weeks. Contraindications include an unfavorable cervix with a Bishop score under 5. Methods include prostaglandins like misoprostol and dinoprostone, oxytocin, and mechanical stripping of membranes. Complications can include failure to deliver, uterine overstimulation, infection, and rupture. Induction decreases C-section risk for post-dates or PROM over 24 hours without increasing other risks.
L32 Abnormal labor
This document discusses abnormal labor, which includes any deviations from normal spontaneous labor of a singleton fetus in cephalic presentation at term. Abnormal labor can occur due to poor progress, fetal compromise, malpresentation, multiple gestation, uterine scar, or induction of labor. Poor progress is defined as less than 2 cm dilation in 4 hours and can be caused by dysfunctional uterine contractions, cephalic-pelvic disproportion, or malpresentation. Malpresentations include abnormal lie, face/brow presentations, breech presentation, and compound presentations. Management depends on identifying the underlying cause based on the 3 Ps - powers (uterine contractions), passages (maternal pelvis), and passenger (fetus).
L31 Normal Labor & Delivery
Normal labor and delivery involves 3 stages: 1) dilation of the cervix, 2) delivery of the baby, and 3) delivery of the placenta. The fetus moves through the birth canal via engagement, descent, flexion, internal rotation, extension, and external rotation. Labor is considered normal if it is spontaneous in onset, involves a single cephalic fetus at term, lasts less than 12 hours for first-time mothers and 8 hours for others, and results in an unassisted vaginal birth.
L30 Perinatal Infections part 2
1. Herpes simplex, Group B streptococcus, chlamydia, gonorrhoea, HIV, hepatitis B, and hepatitis C can all infect both mother and baby during pregnancy and childbirth.
2. Management involves screening, treatment and delivery methods to prevent transmission from mother to baby for these infections.
3. Vaccines are given to babies to prevent hepatitis B infection, while cesarean delivery and antiviral therapy can reduce risk of HIV and herpes transmission.
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L49 Menopause
- 2. The average age of the menopause worldwide is at a median age between 51 and 52 years. Endocrine changes Physiological Menopause
- 3. The diagnosis of menopause is a largely clinical diagnosis that is made according to symptoms experienced. The use of serum endocrine tests are of little value in the perimenopausal years as they are unpredictable due to the hormonal variations. Physiological Menopause
- 4. Premature Ovarian Insufficiency - if menopause occurs before the age of 40 years it is defined as premature ovarian insufficiency (POI - While no cause is found in most cases of primary POI, a suspected case should be investigated Non-physiological menopause
- 5. Iatrogenic menopause – medical treatments and menopause after cancer treatment - Drugs that are GnRH agonists (e.g. buserelin and goserelin) - When administered continuously will down-regulate the pituitary and decrease LH and FSH secretion - This will induce a temporary menopause with a relatively rapid onset. Non-physiological menopause
- 6. Iatrogenic menopause – surgical menopause - Bilateral salpingo-oophorectomy - It is important during preparation that they are aware that as well as losing oestrogen they will also lose the effect of testosterone. Non-physiological menopause
- 7. Vasomotor symptoms How women are affected by the menopause
- 8. Psychological symptoms - depression - low mood - irritability - lack of energy and tiredness - acceleration of the onset or incidence of dementia How women are affected by the menopause
- 9. Endometrial effects - The initial irregular or scanty vaginal bleeding is due to the reduction in estrogenic endometrial stimulation. The urogenital tract and vulvovaginal atrophy - vaginal dryness, irritation, burning, soreness and dyspareunia. - Loss of the estrogenic support to the vaginal epithelium leads to reduced cellular turnover and reduced glandular activity - Incontinence and prolapse worsen during the menopause How women are affected by the menopause
- 10. Bone health - There is a steady decline until the menopause, then an accelerated phase of bone loss until 60 years, followed by further steady decline until death How women are affected by the menopause
- 11. Diet and lifestyle Management
- 13. Hormonal replacement therapy (HRT) If estrogen is given without progestogenic opposition, there is a risk that in time endometrial hyperplasia and cancer may develop. Systemic estrogen-only HRT is suitable for women following a hysterectomy The administration of progestogen is necessary to protect the endometrium. This results in regular monthly menstruation. Management
- 14. Beneficial effects of hormone therapy
- 15.