Perimenopausal Transition — Flashcards

Flashcard 1: In a post-menopausal woman with hyperplasia with atypia, management is done using _____

Answer: hysterectomy

Flashcard 2: Premature menopause is menopause occurring before _____ years.

Answer: 40

Flashcard 3: A minimum of _____ days (in a month) of progesterone added to ERT reduces the risk of endometrial cancer.

Answer: 12

Flashcard 4: Increased risk for breast carcinoma is associated with _____ menarche and late menopause

Answer: early

Flashcard 5: Postmenopausal status is a(n) _____ contraindication to uterine artery embolisation

Answer: relative

Flashcard 6: According to RCOG guidelines, in a patient with suspected post-menopausal ovarian cyst, the first step would be to perform a _____

Answer: USG

Flashcard 7: The postmenopausal endometrium measuring more than _____ mm is considered abnormal

Answer: 4

Flashcard 8: In a post-menopausal woman with complex hyperplasia without atypia, management is done using _____

Answer: progesterone rx

Flashcard 9: In a post-menopausal woman with simple hyperplasia without atypia, management is done using _____

Answer: Progestogens (e.g., Medroxyprogesterone acetate or LNG-IUS)

Extra: The risk of progression to malignancy in endometrial hyperplasia without atypia is low (approximately 1–3%). **Management of Hyperplasia without atypia:** - **Standard treatment:** Progestogens (Oral Medroxyprogesterone acetate or Levonorgestrel-releasing intrauterine system). Progestogens induce regression of the hyperplasia. - **Alternative:** Observation with repeat biopsy (every 6 months) may be considered in asymptomatic women if reversible risk factors (e.g., obesity, HRT) are addressed. **Risk of Malignant Progression (Classic stats):** - Simple without atypia: 1% - Complex without atypia: 3% - Simple with atypia: 8% - Complex with atypia: 29% *Note: In post-menopausal women with **atypical** hyperplasia, the recommended management is total hysterectomy due to the high risk of concurrent or future malignancy.*