Menopause A to Z.pdf - Medwords.com.au

MENOPAUSE A to Z
arthritis) and other less commonly used drugs may also increase bleeding, and therefore bruising.
Women bruise more than men, particularly around the menopause, because hormonal changes may make blood
vessel walls weaker, and allow them to rupture easily. Many women complain of multiple small bruises on their arms
and legs, in places where they cannot recall any significant injury.
Other common causes of abnormal bruising include thrombocytopenia (a lack of platelets in the blood), Cushing
syndrome (over production of steroids in the body, or taking large doses of cortisone), and leukaemia (cancer of the
white blood cells).
When a bruise is likely, or first develops after an injury, the affected area should be cooled with ice, elevated and
rested. The ice should not be applied directly to the skin, but wrapped inside a cloth. Elevation of the area reduces the
pressure in the veins, and slows blood loss from the ruptured blood vessel. Any exercise or movement involving an
area with a ruptured blood vessel will force more blood out into the tissues.
With time and rest the swelling will reduce, the bruise will go from blue/black to purple, brown and finally yellow
before disappearing. There may be some residual swelling and firmness at the bruise site due to the formation of
fibrous scar tissue and the skin over the area may dry out and flake off.
If there is no apparent cause for a bruise, medical advice should be sought.
CHANGE OF LIFE
The term “change of life” is used as a euphemism for the menopause.
CHORIONIC GONADOTROPHIN, HUMAN
Beta human chorionic gonadotrophin (beta HCG or HCG) is secreted by the placenta. The blood level rises to a
peak at 10 weeks of pregnancy, and then slowly declines. Its presence can be used as a diagnostic test for pregnancy,
but can only be detected at least ten days after conception. Its presence also acts as a reliable marker for certain
cancers of the ovary and testes. The interpretation of blood levels are as follows:-
Less than 10 IU/L. - normal non-pregnant.
20 to 100 IU/L - 1 to 2 weeks after pregnancy commences, or menopause
100 to 6000 IU/L - 3 to 4 weeks of pregnancy, or after 6 months of pregnancy, or cancers of ovary or
testicle (embryonal carcinoma or choriocarcinoma).
6000 to 30,000 IU/L - increases between weeks 7 and 30 of pregnancy, and then slowly decreases.
Over 30,000 IU/L - increased risk of Down syndrome (mongolism).
Most HCG tests for pregnancy are performed on urine. The tests indicate whether the HCG is over a threshold level
of HCG and merely indicate a positive or negative result. False positive results can occur with cancers of ovary or
testes (seminomas, choriocarcinoma) or placental tumour (hydatidiform mole). False negatives are far more common
and can occur with very dilute urine, if the pregnancy has not progressed far enough to produce sufficient HCG or with
kidney diseases. The peak level of urine HCG is reached at 10 weeks pregnancy, after which it declines, so a urine
pregnancy test after about 20 weeks of pregnancy may be negative.
Chorionic gonadotrophin can also be injected as a medication in the treatment of infertility in women, delayed
puberty in girls, failure of testicular development and failure of sperm production. It may result in multiple pregnancies
and may cause fluid retention. It must not be used by patients suffering from some types of cancer affecting the sex
organs.
Although chorionic gonadotropin has been prescribed to help some patients lose weight, it should never be used
this way. When used improperly, chorionic gonadotropin can cause serious problems.
CLIMACTERIC
The term “climacteric” is an old fashioned one for the menopause.
CYPROTERONE ACETATE
The antiandrogen (acts against testosterone) hormone cyproterone acetate (Androcur) is used alone in women to
treat excessive body hair, loss of scalp hair and severe acne in women, and in men for the reduction of sexual drive,
premature puberty and cancer of the prostate gland. It is combined with ethinyloestradiol in some contraceptive pills
(eg. Diane) to control acne and oily skin, as well as a being a contraceptive; and with oestradiol valerate to ease the
symptoms of the menopause.
It is not to be used in pregnancy or breastfeeding and adequate contraception must be used in sexually active
women. Do not take it if suffering from severe liver disease, blood clots, sickle cell anaemia, severe depression or
diabetes. It is not to be used in prepubertal girls and is for use in boys only if medically indicated. Use cyproterone with
caution in those with diabetes and liver tumours.
The side effects may include male infertility, reduced libido, tiredness, increased weight, nausea, headache and
irregular menstrual periods. Less commonly breast enlargement in men, depression, breast milk production,
sleeplessness and hot flushes may occur. There is an increased risk of developing a blood clot (deep vein thrombosis).
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