Instructions
This self-assessment study guide has 5 questions, each written using learning objectives from your Menopause lecture. Not all learning objectives are covered. Participation/scores are not monitored. FYI this program makes noise sometimes.
Symbols
A clipboard will bring up relevant patient information.
A lightbulb in the top right corner of a page indicates that the page contains answers or explanations.
Explanation During perimenopause, periods tend to become irregular with heavier bleeding, which is related to lack of progesterone. Vasomotor symptoms often start during perimenopause (a few years prior to final menstrual period) and tend to subside the further out from the final menstrual period (i.e., >5 years after final menstrual period). Mild vulvovaginal symptoms may be helped by vaginal lubricants and moisturizers, which can be obtained without a prescription.
Question 2
For each example, use the provided patient characteristics to determine whether hormone therapy (estrogen +/- progestogen) would be contraindicated (relative or absolute contraindication).
BEGIN
BEGIN
BEGIN
BEGIN
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 1
Not contraindicated Age and time since onset of menopause appropriate.
Patient 2
Contraindicated Over 60 years of age; over 10 years since menopause
Contraindicated History of VTE
Patient 3
Not contraindicated Age and time since onset of menopause appropriate.
Patient 4
Patient 5
Contraindicated Severe liver disesase
Question 3
HP is a 48-year-old woman presenting with complaints of irregular and heavy menstrual bleeding, hot flashes that occur 3-4 times daily, and bothersome night sweats. Her last period was 6 weeks ago. She is sexually active with her husband and has an intact uterus. Her past medical history includes type 2 diabetes and hyperlipidemia, both of which are well-controlled. She takes metformin 500 mg twice daily and rosuvastatin 10 mg daily.
Explanation Since HP is perimenopausal and sexually active, a combined oral contraceptive would be appropriate rather than systemic estrogen therapy (TD, oral estradiol). Estradiol vaginal cream is unnecessary since she is not reporting genitourinary symptoms. Since vaginal cream does not reach systemic levels, it would not treat her other symptoms (irregular/heavy bleeding and hot flashes). Cooling techniques such as cold packs and lowering room temperature could help with her vasomotor symptoms. If the combined oral contraceptive is not used, patient should be educated on pregnancy prevention (e.g., barrier methods, abstinence, surgical options).
Question 4
You will be given descriptions for 7 patients and then be asked to choose the most appropriate therapy from the options listed below. Assume all patients are menopausal.
Therapy options
- Nonpharmacologic therapy
- Vaginal moisturizers
- Vaginal Estrogen
- SNRI/SSRI
- SNRI/SSRI + vaginal moisturizers
- Systemic estrogen therapy
- Systemic estrogen + progestin therapy
Characteristics given for each patient
- Symptoms + severity
- Whether they have contraindications to HRT
- Whether they have an intact uterus
BEGIN
Severe hot flashes/vaginal atrophy No contraindications to HRT Intact uterus
Mild dyspareunia No contraindications to HRT Hysterectomy
Severe hot flashes Has contraindications to HRT Hysterectomy
Mild hot flashes Has contraindications to HRT Intact uterus
Severe hot flashes No contraindications to HRT Hysterectomy
Severe vaginal dryness No contraindications to HRT Intact uterus
Severe hot flashes/vaginal atrophy Has contraindications to HRT Intact uterus
See treatment algorithm
Explanation Oral conjugated estrogen is not preferred over oral estradiol. Oral conjugated estrogen is associated with more adverse events and may have increased risk of thromboembolic events compared to systemic estradiol.
THANK YOU!
Age: 48 Sex: female PMH: T2DM, hyperlipidemia Meds: metformin, rosuvastatin Other relavent history
- Last period 6 weeks ago
- Sexually active w/ husband
- Intact uterus
Complaints
- Irregular & heavy menstrual bleeding
- Hot flashes (3-4 times daily)
- Night sweats
Menopause - mobile
Madeleine Kochis
Created on October 9, 2025
Start designing with a free template
Discover more than 1500 professional designs like these:
View
Vision Board
View
Explainer Video: Keys to Effective Communication
View
Explainer Video: AI for Companies
View
Corporate CV
View
Flow Presentation
View
Discover Your AI Assistant
View
Urban Illustrated Presentation
Explore all templates
Transcript
Instructions
This self-assessment study guide has 5 questions, each written using learning objectives from your Menopause lecture. Not all learning objectives are covered. Participation/scores are not monitored. FYI this program makes noise sometimes.
Symbols
A clipboard will bring up relevant patient information.
A lightbulb in the top right corner of a page indicates that the page contains answers or explanations.
Explanation During perimenopause, periods tend to become irregular with heavier bleeding, which is related to lack of progesterone. Vasomotor symptoms often start during perimenopause (a few years prior to final menstrual period) and tend to subside the further out from the final menstrual period (i.e., >5 years after final menstrual period). Mild vulvovaginal symptoms may be helped by vaginal lubricants and moisturizers, which can be obtained without a prescription.
Question 2
For each example, use the provided patient characteristics to determine whether hormone therapy (estrogen +/- progestogen) would be contraindicated (relative or absolute contraindication).
BEGIN
BEGIN
BEGIN
BEGIN
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 1
Not contraindicated Age and time since onset of menopause appropriate.
Patient 2
Contraindicated Over 60 years of age; over 10 years since menopause
Contraindicated History of VTE
Patient 3
Not contraindicated Age and time since onset of menopause appropriate.
Patient 4
Patient 5
Contraindicated Severe liver disesase
Question 3
HP is a 48-year-old woman presenting with complaints of irregular and heavy menstrual bleeding, hot flashes that occur 3-4 times daily, and bothersome night sweats. Her last period was 6 weeks ago. She is sexually active with her husband and has an intact uterus. Her past medical history includes type 2 diabetes and hyperlipidemia, both of which are well-controlled. She takes metformin 500 mg twice daily and rosuvastatin 10 mg daily.
Explanation Since HP is perimenopausal and sexually active, a combined oral contraceptive would be appropriate rather than systemic estrogen therapy (TD, oral estradiol). Estradiol vaginal cream is unnecessary since she is not reporting genitourinary symptoms. Since vaginal cream does not reach systemic levels, it would not treat her other symptoms (irregular/heavy bleeding and hot flashes). Cooling techniques such as cold packs and lowering room temperature could help with her vasomotor symptoms. If the combined oral contraceptive is not used, patient should be educated on pregnancy prevention (e.g., barrier methods, abstinence, surgical options).
Question 4
You will be given descriptions for 7 patients and then be asked to choose the most appropriate therapy from the options listed below. Assume all patients are menopausal.
Therapy options
Characteristics given for each patient
BEGIN
Severe hot flashes/vaginal atrophy No contraindications to HRT Intact uterus
Mild dyspareunia No contraindications to HRT Hysterectomy
Severe hot flashes Has contraindications to HRT Hysterectomy
Mild hot flashes Has contraindications to HRT Intact uterus
Severe hot flashes No contraindications to HRT Hysterectomy
Severe vaginal dryness No contraindications to HRT Intact uterus
Severe hot flashes/vaginal atrophy Has contraindications to HRT Intact uterus
See treatment algorithm
Explanation Oral conjugated estrogen is not preferred over oral estradiol. Oral conjugated estrogen is associated with more adverse events and may have increased risk of thromboembolic events compared to systemic estradiol.
THANK YOU!
Age: 48 Sex: female PMH: T2DM, hyperlipidemia Meds: metformin, rosuvastatin Other relavent history
- Last period 6 weeks ago
- Sexually active w/ husband
- Intact uterus
Complaints