Updated: 12/19/2018

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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Questions (2)
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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? Tested Concept

QID: 100383
1

Increased serum estradiol and decreased serum LH

7%

(3/42)

2

Increased serum progesterone and increased serum LH

7%

(3/42)

3

Decreased serum estradiol and increased serum LH

67%

(28/42)

4

Decreased serum estradiol and increased serum progesterone

5%

(2/42)

5

Decreased serum progesterone and increased serum testosterone

12%

(5/42)

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