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Menopause Transition Flashcards
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Menopause Transition Flashcards
Menopause Transition GENERAL
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1
Question
What factors can influence ovarian aging and lead to earlier menopause?
Answer
Factors such as environmental influences, genetics, and surgery can alter ovarian aging. Smoking, chemotherapy, radiation, hysterectomy, ovarian surgery, and autoimmune disease can lead to earlier menopause.
2
Question
What causes physical and psychological symptoms during the menopausal transition?
Answer
Erratic fluctuations in female reproductive hormone levels can lead to physical and psychological symptoms during the menopausal transition.
3
Question
What factors explain the variation in symptoms experienced during menopause?
Answer
The variation in symptoms is explained by diet, exercise, reproductive history, socioeconomic status, BMI, mood, climate, and individual/cultural attitudes towards menopause.
4
Question
What are the typical menstrual pattern changes during the menopausal transition?
Answer
Shorter cycles, longer cycles, and irregular bleeding.
5
Question
What vasomotor symptoms are related to the menopausal transition?
Answer
Hot flashes, night sweats, and sleep disturbances.
6
Question
What are the psychological and cognitive symptoms related to the menopausal transition?
Answer
Worsening premenstrual syndrome, depression, irritability, mood swings, poor concentration, and poor memory.
7
Question
What are the sexual dysfunction symptoms related to the menopausal transition?
Answer
Vaginal dryness, decreased libido, and dyspareunia.
8
Question
What are the somatic symptoms related to the menopausal transition?
Answer
Headache, dizziness, palpitations, joint pain, and back pain.
9
Question
What are other symptoms related to the menopausal transition?
Answer
Urinary incontinence, dry skin pruritus, and weight gain.
10
Question
What causes the physiological changes observed during the menopausal transition?
Answer
The atresia of the existing pool of ovarian follicles and the cessation of reproductive hormone production.
11
Question
When does ovarian senescence begin?
Answer
Ovarian senescence begins in utero within the embryonic ovary due to programmed atresia of oocytes.
12
Question
What happens to primary follicles from birth?
Answer
Follicles are continuously activated, partially mature, and then retrogress in a constant pattern independent of pituitary stimulation.
13
Question
When does a more rapid depletion of ovarian follicles begin?
Answer
A rapid depletion of ovarian follicles begins in the late 4th and early 5th decades of life and continues until the menopausal ovary is almost devoid of follicles.
14
Question
What is the main factor that leads to the final loss of ovarian activity and menopause?
Answer
The process of atresia of the non-dominant cohort of follicles, largely independent of menstrual cyclicity.
15
Question
How does the number of follicles differ between women with regular and irregular cycles?
Answer
Women with regular cycles had an average of 1700 follicles, while those with irregular cycles had an average of 180.
16
Question
What are the characteristics of premenopausal ovaries in ultrasound images?
Answer
Premenopausal ovaries generally have greater volume and contain follicles, appearing as multiple, small, anechoic, smooth-walled cysts.
17
Question
What are the characteristics of postmenopausal ovaries in ultrasound images?
Answer
Postmenopausal ovaries have a smaller volume and characteristically lack follicular structures.
18
Question
What is the predominant feature in a reproductive-age ovary when viewed microscopically?
Answer
Primordial follicles.
19
Question
What does a menopausal ovary show microscopically?
Answer
Abundance of atretic follicles and persistent corpora albicantia.
20
Question
What reflects the pool of atretic follicles during the menopausal transition?
Answer
Low levels of inhibin B and anti-Müllerian hormone (AMH), and reduced antral follicle counts measured by ultrasound.
21
Question
When is AMH most appropriately used?
Answer
To assess ovarian reserve in women with infertility.
22
Question
What is AMH and where is it secreted from?
Answer
AMH is a glycoprotein secreted by granulosa cells of secondary and preantral follicles.
23
Question
What does AMH indirectly reflect?
Answer
It reflects the pool of primordial follicles.
24
Question
How do AMH concentrations behave in women of reproductive age?
Answer
AMH concentrations are stable throughout the menstrual cycle and correlate with the number of early antral follicles.
25
Question
How do AMH levels change during the menopausal transition?
Answer
AMH levels decrease markedly and progressively in the menopausal transition, often becoming very low or undetectable about five years before menopause.
26
Question
Where is GnRH released from and how?
Answer
The arcuate nucleus of the basal medial hypothalamus releases GnRH in a pulsatile manner.
27
Question
What does GnRH stimulate in the pituitary gland?
Answer
GnRH binds to GnRH receptors on pituitary gonadotrophs to stimulate the release of LH and FSH.
28
Question
What hormones do LH and FSH stimulate the production of in the ovaries?
Answer
Estrogen, progesterone, and inhibin.
29
Question
How do estrogen and progesterone affect gonadotropin production?
Answer
Estrogen and progesterone exert positive and negative feedback on pituitary gonadotropin production.
30
Question
What effect does inhibin have on pituitary FSH secretion?
Answer
Inhibin exerts a negative influence on pituitary FSH secretion.