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2024 WOMEN'S HEALTH MENOPAUSE EXAM III WITH CORRECT ANSWERS
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2024 WOMEN'S HEALTH MENOPAUSE EXAM III WITH CORRECT ANSWERS
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2024 WOMEN'S HEALTHMENOPAUSE EXAM III WITH
CORRECT ANSWERS
1. Menopause is described as a ______________
2. This happens when a woman reaches what ages?
3. What is menopause marked by?
4. Menopause is a time of menstrual and endocrine changes beginning
___________ - CORRECT-ANSWERS1. a natural decline in reproductive
hormones
2. 40s - 50s
3. marked by the end of menses.
4. (below)
- variation in cycle length
- and ending with the final menstrual period
- (FMP is when 12 months of amenorrhea have passed after last menstrual
period)
What are some non-hormonal approaches for treating menopause? -
CORRECT-ANSWERS*Not as effective as hormones, but do reduce hot
flashes.*
- Studies show 80-100% reduction in hot flashes using estrogen, and a 10-
60% reduction
with SSR/SNRIs.
- Paxil is FDA approved for this, Celexa and Lexapro seem to be as effective
and better
tolerated.
- likely a good option for someone who is
= taking an SSRI for another reason already
= or cannot do HT
What are the SSRI's or SNRI's
What are the considerations? - CORRECT-ANSWERSSSRIs/SNRIs = Paroxetine
or Venlafaxine
+ paroxetine or venlafaxine may benefit women who also have mood
symptoms; whole hot flashes relief will be rapid, depression relief may take 6
- 8 weeks
+ start with the lowest possible dose and increase if patient exhibits no
response after 1 - 2 weeks
, + side effects profile = nausea is dose-related and generally subsides within
2 weeks of initiation + advise patients with drowsiness to use the medication
at night
Can also use Clonidine. What does it do? - CORRECT-ANSWERS- reduces hot
flashes by 15% - 20% compared with placebo in women with a history of
breast cancer.
- mechanism unknown, but thought to be related to reduced vascular
reactivity
What is some non-rx menopause management? - CORRECT-ANSWERSHerbal
medicines:
= primrose oil, Vit E, Omega 3, black cohosh (evidence has insufficient
support to use for vasomotor symptoms) + Isoflavones (soy / red clover) -
some benefit seen in small RCT, reduces hot flashes by 4.3/day compared
Bioidentical Hormones:
= plant-based compounds that contains hormones made equivalently to
hormones made in the body (includes estradiol and micronized
progesterone)
+ FDA approved versions of two "bioidentical" hormones
+ "Salivary testing" - inaccurate and unreliable
Lifestyle Changes:
- Avoiding triggers/maintaining a cool environment
- Physical exercise
- Weight loss in overweight or obese patients
- Acupuncture
- Mindfulness and relaxation practices (meditation, breathing exercises,
yoga, muscle relaxation) - lack of significant benefit seen, few studies,
generally few studies, generally poor quality design - similar MOA as CB
Someone who is 65 and postmenopausal calls with vaginal dryness. What
non-hormonal therapies are you suggesting? - CORRECT-ANSWERS- water-
tased or silicone-based lubricants applied to the vaginal Introits before
intercourse (also can help dyspareunia related vaginal dryness)
- vaginal moisturizers trap moisture and improve vaginal dryness, pH
balance, and elasticity and reduce vaginal itching, irritation, and dyspareunia
to vaginal dryness
Someone who is 65 and postmenopausal calls with vasomotor symptoms.
What hormonal treatment are you going to prescribe? - CORRECT-ANSWERS-
in women without vasomotor symptoms or other indications for systemic
MHT, offer vaginal/local estrogen therapy
- acceptable regimens = estradiol (ring, tablet, cream) or conjugated
estrogen cream
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