Women's Health: Hormone and Sexual Dysfunction, Osteoporosis

T/F: Menopause is defined as the final menstrual period and reflecting loss of ovarian follicular function that leads to permanent amenorrhea (Recognized after 12 months of amenorrhea).

• True

• False

Which of the following is TRUE about the STRAW + 10 Staging System?

• All stages have increased variability in menstrual cycle

• Late Reproductive Stage (Stage -3): Fecundability begins to decline

• Early menopausal transition (Stage -2): defined as persistent difference of 7 days or more

• Late Menopausal Transition (Stage -1): Prevalence of Anovulation

• Late Postmenopause (Stage +2): FSH continues to increase

Answer explanation

Late reproductive stage (Stage -3)

 fecundability begins to decline

 a woman may begin to notice changes in her menstrual cycles

Early menopausal transition (Stage -2)

 increased variability in menstrual cycle

 length, defined as a persistent difference of 7 days or more

 in the length of consecutive cycles

Late menopausal transition (Stage -1)

 increased variability in cycle

 length, extreme fluctuations in hormonal levels, and increased

 prevalence of anovulation

Early postmenopause (Stage +1a, +1b, +1c)

 FSH continues to increase

 estradiol continues to decrease until approximately 2 years after the FMP

Late postmenopause (Stage +2)

 further changes in reproductive endocrine function are more limited

 processes of somatic aging become a concern

Which of the following are Menopause Symptoms?

• Increased Facial Hair

• Sleep Disturbance

• Genitourinary atrophy

• Post-meno. Osteoporosis

• Mood Changes

Answer explanation

MENOPAUSE SYMPTOMS

 Sleep disturbances

 Thin, less elastic skin

 Increased facial hair

 Thin nails

 Mood changes

 Cardiovascular lipid changes

T/F: Perimenopause is lab test is determined as FSH on days 2 or 3 of menstrual cycle greater than 30 IU/L

• True

• False

Answer explanation

Perimenopause

 FSH on day 2 or 3 of menstrual cycle >10-12 IU/L

Menopause

 FSH > 30 IU/L

Which of the following is TRUE about menopause therapy?

• Hormone therapy replacements include estrogen or progestin only medications

• Treatment of estrogen deficiency

• Untreated estrogen deficiency may lead to endometrial hyperplasia and increase risk of endometrial adenocarcinoma

Which of the following formulations are available for conjugated estrogens?

• Tablet

• Cream

• Vaginal Ring

• Patch

• Gel

Answer explanation

Slide 10

T/F: Continuous-combined therapy schedule includes daily estrogen with addition of progesterone added 10-14 days out of every 4 weeks

• True

• False

Which of the following is TRUE about PREMPRO?

• It is a continuous-combined therapy schedule.

• Contains estrogen only

• Given as 28-day dial-pack

• Has one strength

• 14 tablets contain both estrogen and progestin

Which of the following is TRUE about combination therapy side effects?

• Back pain

• Feeling cold

• Breast complications (enlargement/tenderness)

• Abdominal cramps

• Skin Flushing

Answer explanation

Slide 14

Which of the following is TRUE about genitourinary atrophy?

• Caused by decreased progestin contcetrions.

• Labia minora & majora shrink and flatten

• Vaginal epithelium becomes thick and red.

• Increased risk for infections

• Progestin therapy is indicated for treatment