MAHAVIR COLLEGE OF NURSING
VATRAK
SUB : - OBSTETRICS AND GYNECOLOGY
TOPIC : - SEMINAR ON
MENOPAUSE
DATE : - 15/07/2025
SUBMITTED TO, SUBMITTED BY,
Mr.Balveer Solanki Ms. Snehal Parmar
Assistant Lecturer First year M.Sc. Nursing
MCONV MCONV
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MENOPAUSE
INTRODUCTION:
• Menopause is the end of menstruation.
• The word menopause came from the Greek word 'meno' meaning ‘monthly’
and ‘pausis’ meaning ‘cessation’.
• Menopause is a part of a women’s natural ageing process when her ovaries
produce lower level of the estrogen and progesterone.
DEFINITIONS:
• Menopause means permanent cessation of menstruation at the end of
reproductive life due to loss of ovarian follicular activity. It is the point of
time when last and final menstruation occurs.
• Menopause is the permanent cessation of menstruation at the end of
reproductive life due to loss of ovarian follicular activity.
AGE OF MENOPAUSE:
• Age is genetically predetermined. The age of menopause is not related to
age of menarche or age at last pregnancy.
• Cigarette smoking and severe malnutrition may cause early
menopause. Early
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menopause is seen in cases following
chemotherapy, ovarian resection.
• The age of menopause 45-55 years
• Average 50 years. PHASES OF
MENOPAUSE:
• Pre-menopause
• Peri-menopause
• Menopausal phase
• Post menopause
PREMENOPAUSE is defined as no symptoms of menopause or
perimenopause. Pre menopause lasts an average of 30 to 35 years.
Some of the most common symptoms are:
• Irritability
• Anxiety
• Headaches
• Abdominal cramps
• Breast tenderness
PERIMENOPAUSE is the time starting few years before continuing after the
period of onset of menopause.
The most characteristic symptoms are:
• Irregular periods
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• Mood swings
• Hot flashes
• Night sweats
• Vaginal dryness
• Loss of libido
MENOPAUSE means Once a woman has gone 12 consecutive months
without a period, she has officially entered menopause.
POSTMENOPAUSE is the last phase of menopause, that comes after the
menopause.
The common symptoms are:
• Osteoporosis
• Incontinence
• Urinary tract infections
• Heart disease
• Dyspareunia
CAUSES OF MENOPAUSE:
• Surgical removal of the ovaries
• Chemotherapy and radiation therapy OTHER SYMPTOMS:
1)MENSTRUAL CHANGES:
• Short cycles
• Irregular bleeding
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2) VASOMOTOR SYMPTOMS:
• Hot flashes
• Night sweats
• Anxiety, lack of sleep
3) PSYCHOLOGICAL SYMPTOMS:
• Irritability
• Mood swings
• Poor memory
• Depression
4) SEXUAL DYSFUNCTION:
• Vaginal dryness
• Loss of libido
5) URINARY:
• Incontinence
• Urgency
• Dysuria
6) OTHER SYMPTOMS:
• Back aches
• Joint aches
• Weight gain
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TESTS:
HISTORY COLLECTION:
• Menopause is usually considered complete after 1 year of amenorrhea.
• Tests typically aren’t needed to diagnose menopause:
• But under certain circumstances, doctor may recommend blood tests to
check your level of FSH and estradiol and Thyroid Stimulating
Hormone(TSH).
DIAGNOSIS:
• Average age of menopause 50 years
• Appearance of menopausal symptoms
• Vaginal cytology.
MANAGEMENT:
1)TREATMENT
• A) Non-harmonal treatment
• B) Harmone therapy
2)PREVENTION
3)COUNSELLING
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1) TREATMENT:
A) NON-HORMONAL TREATMENT:
• 1)Life style modification
• 2)nutritious diet
• 3)supplementary calcium and vitamin D
• 4)exercise
• 5)vitamin E
1. Lifestyle modification: this includes physical activity (weight-
bearing), reducing high coffee intake, smoking and excessive alcohol.
2. Nutritious diet: balanced with calcium and protein is helpful.
3. Supplementary calcium: daily intake of 1-1.5g can reduce
osteoporosis and fracture.
4. Vitamin-D: supplementation of vitamin D3(1500-2000IU/day)
along with calcium
and can reduce osteoporosis and fractures. Exposure to sunlight
enhances synthesis of cholecalciferol (vit.D3) in the skin.
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5. Exercise: weight bearing exercises,
walking and jogging.
6. Vitamin E: vitamin E reduces hot
flashes (25%).
B) HORMONE THERAPY:
• The Hormone Therapy (HT) is indicated in menopausal women to
overcome the short-term and long-term consequences of estrogen
deficiency.
INDICATIONS OF HORMONE THERAPY:
• Relief of menopausal symptoms
• Relief of vasomotor symptoms
• Prevention of osteoporosis
SPECIAL GROUP OF WOMEN TO WHOM HT SHOULD BE
PRESCRIBED:
• Premature ovarian failure
• Surgical or radiation menopause
BENEFITS OF HORMONE THERAPY:
• Improvement of vasomotor symptoms (70- 80%)
• Increase in Bone mineral density (2-5%)
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• Decreased risk in hip fractures (25-50%)
• Reduction in colorectal cancer (20%)
CONTRAINDICATIONS OF HORMONE
THERAPY
• History of breast cancer
• Undiagnosed genital tract bleeding
• History of Deep Vein Thrombosis (DVT)
• Active liver disease
• Prior Endometriosis
RISKS OF HORMONE THERAPY:
• Endometrial cancer
• Breast cancer
• Venous thromboembolic (VTE) disease
• Coronary heart disease (CHD)
• Dementia, Alzheimer
AVAILABLE PREPARATION FOR
HORMONE THERAPY:
• ORAL ESTROGEN REGIME
• ESTROGEN AND CYCLIC PROGESTIN
• TRANSDERMAL ADMINISTRATIONS
• SUBDERMAL IMPLANTS
• PERCUTANEOUS ESTROGEN GEL
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• TRANSDERMAL PATCH
• VAGINAL CREAM
• PROGESTINS
• LEVONORGESTREL INTRAUTERINE SYSTEM
(LNG-IUS)
• TESTOSTERONE
• PARATHYROID HORMONE
DURATION OF HT USE:
• Most women are able to stop taking HRT after their menopausal
symptoms finish, which is usually two to five years after they start (but in
some cases this can be longer).
• Gradually decreasing your HRT dose is usually recommended, rather
than stopping suddenly.
2) PREVENTION:
• Spontaneous menopause is unavoidable.
• However artificial menopause induced by surgery, radiation or
chemotherapy during reproductive period can to some to extent be
prevented or delayed.
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3) COUNSELING:
• It is important to understand the individual’s need and priorities when
providing counselling.
• KEY POINTS:
• The decision-making process
• Problem reported by women.
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