Updated: 3/23/2022

Menopause

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  • Overview
    • Menopause
      • signals end of menstrual cycles and reproductive function in females
      • progressive loss of ovarian follicle units (atresia) throughout reproductive life causes a decrease in ovarian production of estrogen and reduces negative feedback to anterior pituitary, leading to an increase in FSH and LH levels
      • typically preceded by several years of abnormal menstrual cycles
        • e.g., anovulatory cycles
      • diagnostic findings include ↓ estrogen, ↑↑ FSH, ↑ LH, ↑ GnRH
      • in post-menopausal women, source of estrogen includes ovary and adrenal cortex
        • via peripheral aromatization of androgens
          • adrenal cortex (major) and ovary (minor) are sources of androstenedione
            • ↑ androgens result in a male pattern hair growth (mainly on the face)
      • average age of menopause is 50 years
        • onset early in smokers
        • early menopause may indicate premature ovarian failure
    • Menopause symptoms
      • symptoms are caused by loss of ovarian source of estrogen
        • male-pattern hair growth in women via ↑ androgens
        • hot flashes (vascular instability)
        • atrophy of vagina (thinning of vaginal epithelium)
        • ↓ vaginal secretions
        • osteoporosis
        • coronary artery disease

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(M1.RP.12.82) A 52-year-old female presents with a primary complaint of amenorrhea for the past 6 months. She also reports dyspareunia, recurrent headache, and infrequent episodes of night sweats. Diagnostic work-up reveals increased serum FSH levels. Which additional laboratory findings would most likely be seen in this patient?

QID: 100383

Increased serum estradiol and decreased serum LH

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(9/115)

Increased serum progesterone and increased serum LH

3%

(4/115)

Decreased serum estradiol and increased serum LH

75%

(86/115)

Decreased serum estradiol and increased serum progesterone

7%

(8/115)

Decreased serum progesterone and increased serum testosterone

5%

(6/115)

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