Menopause

Menopause

Causes
1. High levels of pituitary & low levels of ovarian hormones
2. Chemotherapy & Radiation
3. surgical intervention- hystrectomy
Clinical Manifestations
1. No periods for 1 year
2. 48-55yrs of age
3. Climateric, Perimenopausal
  Anotações:
  - Overian Function begins to decline
  1. Irregular Periods
  2. Wake up during the night
  3. Increase in irritability
  4. Migraines
  5. Fatigue (often urinate durning the night)
  6. Poor Concentration
  7. loss of libido
  8. Inability to multitask
  9. Vaginal Dryness
4. Postmenopausal
Complications
1. Osteoporosis
2. Vaginal Dryness
3. Heart Disease
4. Poor Bladder & Bowel Function
5. Poor Muscle tone or loss of muscle
6. Deterioration of Vision
7. Psychosocial - 1) sense of loss 2) decrease of self esteem 3) depression
Interventions
1. HRT- estrogen & Progesterone
  Anotações:
  - Hormone Replacement Therapy
  1. Prevent Uterine Cancer (Combination Therapy)
  2. Esterogen only more at risk for blood clotting, cancer & strokes
    Anotações:
    - Hystrectomy only needs estrogen.
  3. Contraindications: uncontrolled hypertension, unexplained vaginal bleeding, impaired liver function, active thromboembolic disease, prophyria, breast cancer
  4. Estrogen- Naseau, fluid retention, headache, & breast enlargement
  5. Progesterone- increased appetite, weight gain, irritability, depression, spotting, breast tenderness
    1. Report immediately of sudden loss of vision, severe headache, chest pain, hemoptysis, pain in the calves (especially swelling/redness), numbness in arm or leg, abd. pain or tenderness
  6. Pill, Transdermal Patch or injection
2. Weight Bearing Excercise, Calcium, Biphosponates
  Anotações:
  - Biphosphonate suppress reabsorption.
3. Breast exam, Pap smear
4. Premature Ovarian Insufficiency
5. Selective estrogen Receptor Modulator
  Anotações:
  - Competes with estrogen for estrogen receptor sites. *It decreases bone loss & decrease serum cholestrol with minimal effects on breast & uterine tissue
6. Non hormonal therapy
  1. Exercise & increase sleep & decrease alcohol/caeffine
  2. SSRI
  3. Clonadine/Gabapentin (hotflashes)
  4. Keep Cool Environment
  5. Relaxation Techniques
  6. Increase air circulation in the room & avoid heavy bedding
7. Alternative
  1. Bio-identical
  2. Massage
  3. Ask if they are on Herbs
Labs
1. may still have increased FSH & LH
2. Drop in Progesterone & Esterogen

Anexos de mídia

Menopausepic (binary/octet-stream)

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Anexos de mídia

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	Criado por Ilana Kovach quase 7 anos atrás