04.04 Menopause

Hey guys, today’s lesson is on menopause. By the end of the lesson you’ll have a better understanding of what menopause is, the symptoms you’ll see, lab testing that is performed, and treatment options available for this condition.

So menopause is a normal, expected, and irreversible condition associated with aging in women, caused by a natural decline in reproductive hormones that marks the end of a woman’s reproductive period. Menopause is diagnosed after 12 months of amenorrhea , which is the absence of menstruation, or missing periods. So they’ve missed their period for 12 consecutive months. The average age for menopause is about 50 years of age.

So let’s review the patho behind menopause. So basically menopause is due to variations in hormone levels because the ovaries become less sensitive to stimulation. So this starts with an anovulatory cycle, which is when the body skips ovulation. The body loses its regulatory, monthly cycles which become more common. All of these things eventually leads to the final menstrual period and permanent amenorrhea.

Alright guys so let’s look at some of the symptoms that menopausal patients can experience. Symptoms can start up to 6 years before the woman’s last period and can continue for a variable number of years after as well. So as you can see with this list, the symptoms are kind of all over the place. Many of the symptoms are due to the changing hormone levels associated with menopause. Hot flashes are the most common symptom and are when the woman gets flushed, sweaty, and overall just really hot until the episode resolves. A lot of times the hot flashes occur at night which can cause insomnia as well. Weight gain and bloating can occur due to the hormonal changes as well as mood changes like depression. Now depression can be attributed to the hormone changes but it can also be due to the stage of life they are entering. Breast pain and headaches are also common findings mostly due to the hormone changes as well. Decreased estrogen in the body can lead to osteoporosis. Finally, patients can have reproductive and urinary changes like irregular menses, vaginal dryness, painful intercourse, and prolapse of reproductive or urinary structures.

So really there aren’t many diagnostic tests out there to determine if a patient is going through menopause. Usually the provider will order some lab testing and use their assessment findings to make the diagnosis. So the patient’s FSH level will be elevated, which tells us that menopause has occurred. On the other hand, estrogen and inhibin will both be decreased due to changes in hormone production.

Treatment usually consists of hormone replacement therapy which basically is what the name implies - we are replacing the hormones the body doesn’t make anymore after menopause. Hormone replacement therapy, or HRT are different medications with combinations of estrogen and progesterone. By replacing the hormones, this can help relieve some of the patient’s symptoms like irregularity of menstrual cycles, and can overall just improve the patient’s quality of life. HRT also helps preserve bone and helps treat osteoporosis as well. In addition to HRT, we will treat the patient’s symptoms individually as needed.

One of the things we will be teaching our patient’s about is how to manage their symptoms, as that is the most troublesome part of menopause. So for example, if your patient is having hot flashes, you could teach them to dress in layers, or to sleep with a fan on at night to try to help with them. We will also be teaching about hormone replacement therapy medications if they are ordered.

Okay guys so one of the nursing concepts is an alteration in coping, because menopause is a big life event for women, and means that the reproductive years are over, which is difficult to come to terms with for many women. There is also an alteration in hormone regulation, as that is how menopause begins in the first place. Finally, there is an alteration in reproduction, because menopause ends the woman’s reproductive years, which means that they are no longer fertile.

So one of the key points I want you to remember from today’s lesson includes the symptoms you’ll see. So if you remember, there are many symptoms the patient can have, but hot flashes are the most common symptom. Lab testing includes FSH levels, which will be increased and estrogen and inhibin will both be decreased. Treatment options include hormone replacement therapy, which helps replace the hormones the body no longer makes after menopause, which helps with relief of symptoms. Treatment also includes symptom management, so treating the individual symptoms as needed. Finally, patient education is aimed at medication education if that is indicated, as well as teaching the patient how to manage the symptoms they are experiencing.

Okay guys, that is all on our lesson on menopause. Make sure to check out the other resources attached to this lesson. Now, go out there and be your best self today, and as always, Happy Nursing!