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Menopause

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Topic updated on 12/29/16 12:01pm

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 causes hirsutism
    • 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
      • hirsutism (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.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? Topic Review Topic

1. Increased serum estradiol and decreased serum LH
2. Increased serum progesterone and increased serum LH
3. Decreased serum estradiol and increased serum LH
4. Decreased serum estradiol and increased serum progesterone
5. Decreased serum progesterone and increased serum testosterone

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