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Education and information on subtle physiologic

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Education and information on subtle physiologic changesDiscussion about health promotion/disease prevention strategies.Nursing consideration:Sexuality, fertility, contraception use, and STIsUnintended pregnancy without contraceptionOral contraceptive provide protection against uterine cancer, ovarian cancer, anemia,pregnancy, and fibrocystic breast changes as well as relief from peri-menopausal symptomsWomen who smoke, 35 years or older should not take oral contraceptive agents because ofan increased risk of CVD.Breast health discussion, about16% of breast cancer cases occur in peri-menopausal womenBreast self-examination, annual physical examinations/mammograms are essential.
MenopausePermanent physiologic cessation of menses associated with declining ovarian after 1 yrof menses cessation function(Ovulation occurs less frequently, estrogen levelsfluctuate, and FSH levels increase)Changes in menstruation (increase/decrease, irregular, and finally cease)Clinical manifestations:↑ in body fat/intra-abdominal deposition of fat, ↑ total and LDL cholesterol, hot flashes,hormonal changes = irregular mensesBreast tenderness, mood changes long before menopause occurs, sweating causingdiscomfort, sleep disturbances, fatigue, ↑ bone loss/densityFatigue, forgetfulness, weight gain, irritability, trouble sleeping, gradual thinning of pubichair/shrinkage of the labia.Vaginal secretions decrease, dyspareunia (discomfort during intercourse), ↑ vaginal Ph =predisposing women to bacterial infections/atrophic vaginitis, discharge, itching, and vulvarburning.
MenopausePsychological considerations:feeling “blue,”/ panic, feelings related to loss of reproductive capacity, experience roleconfusion, experience a sense of sexual/personal freedom.Relieved of childbearing phase, personal views about menopause considered on anindividual basis. Nurses need to be sensitive to all possibilities and take their cues from thepatient.Medical management:Hormone Replacement Therapy (HRT) for estrogen or estrogen and progestin treating hotflashes/sweating,Risks and benefits:Hormone Therapy (HT) contraindicated in women history of breast cancer, vascularthrombosis, impaired liver function, uterine cancer, and undiagnosed abnormal vaginalbleeding.Risk of venous thromboembolism is increased with HT, educated on signs and symptoms ofDVT, pulmonary embolism (PE), reportsigns and symptoms (i.e., leg redness, tenderness,chest pain, shortness of breath) immediately.Educate on importance of regular follow-up care, yearly physicalexamination/mammogram.Endometrial biopsy indicated for any irregular bleeding.
Nursing Education for the Patient Approaching MenopauseView as natural life change, a new phase with potential for growth andnew activitiesPromote general good health, including diet and exerciseAddress sexual activity and prevention or management of commonproblemsAlternative therapy for hot flashes

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