Slide 9 menopause menstrual changes can be rapid and

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Slide 9 Menopause Menstrual changes can be rapid and abrupt or gradual. Cycles may be irregular for a time. They may shorten or lengthen. Some women experience periods with heavy bleeding prior to menopause.
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Slide 10 Endocrinology of Menopause Relative cessation of estrogen and progesterone production by the ovaries. Some small estrogen production may continue for as long as 10 years after menopause. Slide 11 Endocrinology of Menopause Relationships between hormones stay the same, so: Very low estrogen stimulates GnRH GnRH stimulates FSH and LH Not much estrogen produced in response to LH and inhibin very low. GnRH increases, then FSH and LH increase GnRH, FSH and LH levels high post- menopause (opposite of pre- puberty). Slide 12 Endocrinology of Menopause No decrease in sex steroids from the adrenal cortex. Androstenedione from adrenal cortex becomes precursor of estrone. Conversion of androstenedione to estrone occurs in fat. Higher body fat = higher estrone. Obese women often show fewer symptoms of estrogen decline.
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Slide 13 Estrogen (Replacement) Therapy - ERT ERT = daily treatment with estrogen either orally or by skin patch. Increased risk of endometrial cancer so it is rarely used for women with an intact uterus. Slide 14 Hormone (Replacement) Therapy - HRT Sequential administration of estrogen and then progesterone (pills or skin patch). Results in cyclic bleeding (periods). Slide 15 Hormone (Replacement) Therapy - HRT Does not result in an increased risk of endometrial cancer…BUT this treatment may increase the likelihood of developing Alzheimer’s disease. Recent work suggests increased death rate if develop lung cancer.
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Slide 16 ERT & HRT Replacement therapies have serious risks Should only be used to treat symptoms
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  • Fall '07
  • Kenney
  • Psychology, Postmenopause, Endocrinology of Menopause

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