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Menopause Therapeutics exam with complete solutions 2024_2025.
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Menopause Therapeutics exam with complete solutions 2024_2025.
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Menopause Therapeutics exam withcomplete solutions 2024/2025
perimenopausal
onset of menstrual irregularity
perimenopausal FSH
•FSH >10-12 IU/L on first 2-3 days of menstrual cycle
•12 consecutive months of amenorrhea
menopause FSH
•FSH >40 IU/L; ovaries have ceased function
do females who had a hysterectomy have symptoms of menopause?
•Females who have had a hysterectomy (removal of uterus) may or may not have
symptoms of menopause
vasomotor symptoms
•Hot flashes, night sweats, sleep disturbances, mood changes
Vulvovaginal Atrophy (VVA)/Genitourinary Symptoms of Menopause (GSM)
•Vulvovaginal dryness, irritation or itching, vaginal discharge
•Dyspareunia: difficult or painful intercourse
•Urinary symptoms of urgency, dysuria or recurrent UTIs
goals of therapy
•Decrease symptoms or severity of symptoms
•Improve quality of life
•Address modifiable risk factors
decrease symptoms or severity of symptoms
•Continue treatment for at least one month to assess treatment effect
•Side effects leading to discontinuation?premenstrual like symptoms; vaginal
bleeding
address modifiable risk factors
smoking, BMI, alcohol use, diet
MHT, HT, HRT
, •MHT = Menopausal hormone therapy
- Preferred broad term used to describe estrogen therapy or estrogen + progestin
therapy
•HT = Hormone therapy
•HRT = Hormone replacement therapy
According to the North American Menopause Society (NAMS) Position Statement,
what remains the most effective treatment for VMS/GSM and is shown to prevent
bone loss and fracture?
•Hormone Therapy remains the most effective treatment for VMS/GSM and is
shown to prevent bone loss and fracture. Individualized treatment approach that
considers risk to benefit
what does ACOG recommend for HRT?
•Lowest dose of HRT
•Shortest duration possible
•Decrease possible risks of ADEs
MRT absolute contraindications
•Undiagnosed abnormal genital bleeding
•History of breast cancer
•Estrogen or progesterone-dependent neoplasia
•History or active VTE/DVT
•Active/recent thromboembolic diagnosis: MI/Stroke
•Liver disease
MRT relative contraindications
•Uncontrolled HTN
•Hypertriglyceridemia
•Impaired liver function
•Fluid retention
•Severe hypocalcemia
•Ovarian cancer
•Exacerbations of endometriosis
Evaluating CVD risk in women contemplating MHT
vasomotor only sxs tx
mild: nonpharm + modifiable risk factors
moderate-severe: hormone therapy?
vasomotor AND vulvovaginal/GSM sxs tx
mild: nonpharm + modifiable risk factors (moisturizers or lubricants)
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