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Women's Health Exam III – Menopause Exam 2024 Update
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Women's Health Exam III – Menopause Exam 2024 Update 1. A routine health and risk assessment may include ____________ - ANSWER-1. (below) + pelvic examination + pap + breast exam + mammogram + +/- sonography + cardiovascular risk profile (BP, Lipids, Diabetes)

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  • September 17, 2024
  • 20
  • 2024/2025
  • Exam (elaborations)
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  • Women's Health III – Menopause
  • Women's Health III – Menopause

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Women's Health Exam
III – Menopause Exam
2024 Update




1. A routine health and risk assessment may include ____________ -
✔✔✔ANSWER-1. (below)
+ pelvic examination
+ pap
+ breast exam
+ mammogram
+ +/- sonography
+ cardiovascular risk profile (BP, Lipids, Diabetes)

,1. Can we use hormone levels to diagnose menopause?
2. what are the hours to hour changes like? - ✔✔✔ANSWER-1. Although the
hormones LH and FSH (especially FSH) are trending upward in menopause
2. the actual levels hour to hour can be very erratic and that is why hormone testing
for menopause is considered to be very unreliable.


1. During perimenopause, what happens to estrogen levels?
2. How long does perimenopause last usually? - ✔✔✔ANSWER-1. During this
time, estrogen levels fluctuate, which can cause heavy, irregular periods and
cramping.
2. 5 years


1. How much do you use for systemic symptoms?
2. How do you prescribe hormones for someone
3. What about long term use? What are you concerned about? - ✔✔✔ANSWER-1.
Use lowest dose effective for symptoms
2. If early/induced menopause, use at least to usual age of menopause
3. Longer-term use is appropriate for some women and it is an individual decision
weighed against the potential risk of breast cancer (seen in WHI after 3-5 years of
use of E+P, data is considered controversial and cases were infrequent (9/10,000)).
E alone use might be supported for longer. There is no age at which you must
withdraw, it's individualized based on patient's health status, risks, and symptoms.




1. _________ of women have GU changes - unlike hot flashes which tend to
subside in some years
2. GU changes are ____________

, 3. Vaginal atrophy is when __________ also the vagina is more susceptible to
___________
4. Where does atrophy happen?
5. what other kind of symptoms are there? - ✔✔✔ANSWER-1. 90%
2. progressive and without natural end
3. tissue becomes thinner, drier, and more susceptible to injury, inflammation, and
even infection because hormone changes change the flora of the vaginal
environment (more prone to BV infections).
4. atrophy of the urethra, cervix, uterus
5. urinary symptoms


1. in 2001, the ANA study showed that:
2. In 2002 the WHI study showed that:
+ about breast cancer?
+ was the data stratified?
+ what types of hormones used?
+ what kind of hormones were used and could it be generalized?
+ what did it have to say about older age groups? - ✔✔✔ANSWER-1. ANA =
taking HRT postmenopausal could be preventative of Alzheimer's, cardiovascular
disease, osteoporosis
2. WHI = (below)
- increased diagnosis of breast cancer, stroke and VTE (faulty study)
+ no stratification of data
+ only one strain of estrogen and estrogen-progesterone used
+ ET and EPT - risks only found in EPT, should not have been generalized to both
ET and EPT
+ risks increased in older age groups

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