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  #1  
Old 07-30-2013
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Question Menopause Management

A 47-year-old female comes to you complain of disturbed sleep, abdominal pains, decreased libido, dry vagina and such. What is the next best step in management?

A) Pregnancy test
B) Check LH levels
C) Give Estrogen therapy
D) Give topical steroids for her vagina
E) Give topical estrogen for her vagina
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Old 07-30-2013
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A) Prego test

Never give estrogen on its own...
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Quote:
Originally Posted by DocSikorski View Post
A) Prego test

Never give estrogen on its own...
Mr. Sikorski... we meet again...

ps. yes, thats what I answered on my comp but all my dumbass friends are on my case saying nono its estrogen therapy. even though she's 47 she still can get preggo right so thats first step innit.
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Old 07-30-2013
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Quote:
Originally Posted by Dr.NickRiviera View Post
Mr. Sikorski... we meet again...

ps. yes, thats what I answered on my comp but all my dumbass friends are on my case saying nono its estrogen therapy. even though she's 47 she still can get preggo right so thats first step innit.
Indeed!

Nope, unopposed estrogen is never an answer...
It leads to terrible things...
Women explode and their face melts off if they receive unopposed estrogen
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Originally Posted by DocSikorski View Post
Indeed!

Nope, unopposed estrogen is never an answer...
It leads to terrible things...
Women explode and their face melts off if they receive unopposed estrogen
worrrrrd!?

so what's the indication for estrogen therapy, if not menopausal symptoms? menopausal symptoms are treated just supportively then?
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Originally Posted by Dr.NickRiviera View Post
worrrrrd!?

so what's the indication for estrogen therapy, if not menopausal symptoms? menopausal symptoms are treated just supportively then?
Its estrogen + progesterone thats callet HRT therapy
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Originally Posted by DocSikorski View Post
Its estrogen + progesterone thats callet HRT therapy
oh trueeee
so when do we give just estrogen? never? not even for like their weak ass bones and shiet?
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Quote:
Originally Posted by Dr.NickRiviera View Post
oh trueeee
so when do we give just estrogen? never? not even for like their weak ass bones and shiet?
Not as far as I know, I might be wrong though
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thats cuz unopposed estrogen leads to constant endometrial proliferation....

Well maybe in a woman with total hysterectomy it would be fine though
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Originally Posted by DocSikorski View Post
thats cuz unopposed estrogen leads to constant endometrial proliferation....

Well maybe in a woman with total hysterectomy it would be fine though
yea true, that all sounds about right
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Old 07-31-2013
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Quote:
Originally Posted by Dr.NickRiviera View Post
Q: a 47-year-old female comes to you complain of disturbed sleep, abdominal pains, decreased libido, dry vagina and such. What is the next best step in management?

A) Pregnancy test
B) Check LH levels
C) Give Estrogen therapy
D) Give topical steroids for her vagina
E) Give topical estrogen for her vagina
Dr.NickRiviera can you please tell what's the source of this question and if DocSikorski's answer is a correct one?
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Old 07-31-2013
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Instinctively thought there would be a "check FSH levels" answer. You know, to diagnose menopause.
Out of curiosity, can you diagnose menopause using LH levels?
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I think you'll need both.
You'll need the ratio of FSH/LH to be 2/1 to diagnose it
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Old 08-08-2013
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Quote:
Originally Posted by Casandra View Post
Dr.NickRiviera can you please tell what's the source of this question and if DocSikorski's answer is a correct one?
my school requires us to do an nbme sponsored COMP exam, so nbme questions, but worry not! you'll never see this exact question so its not a spoiler.
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Old 10-04-2014
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dang, I went straight for the LH. LH would be high in menopause and PCOS...
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