Mary’s Health Part C: Menopause

Due to Mary’s clinical condition, age, high risk for fractures and post menopausal hormone changes, Mary may require hormone replacement therapy (HRT) to regulate her hormone levels.

The anterior pituitary gland stimulates the production of follicle stimulating hormone (FSH), which facilitates the production of the hormones Estrogen and Progesterone in the ovaries.

FSH= Estrogen & Progesterone

Image illustrates the anterior and posterior pituitary glands. 
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Hormones

Estrogen

  • Regulates menstrual cycle and reproductive tract
  • Facilitate young women undergoing puberty
  • Responsible for the development of sex organs

Progesterone

  • Released primarily when a woman is pregnant
  • Relaxes the uterine smooth muscles for dilation and delaying contractions

Estrogen and progesterone are produced by Granulosa cells of the ovaries.

What is menopause?

  • Defined by 1 year of amenorrhea in women
  • Typically occurs around the age of 50
  • Fertility, reproductive function & metabolism declines with age
  • Decreasing release of reproductive hormones

Declining estrogen levels increases the rate of bone reabsorption and increases osteoclast activity, in which the bone becomes porous and weak

Osteoblasts: bone building cells

Osteoclasts: bone crushing cells

Normal                                       Osteoporosis

Image shows the difference between normal vs. Osteoporosis bone cells. Image shows the difference between normal vs. Osteoporosis bone cells. 
CC-BY- SA 3.0 https://commons.wikimedia.org/wiki/File:Bone_normal_and_degraded_micro_structure.jpg

Critical Thinking & Application

What is the relationship between Calcium and Phosphate in bone breakdown and repair physiology?

The relationship between Calcium and phosphate simply is that Calcium builds bones and repairs/ strengthens the skeletal system, while phosphorus actively breaks down and reabsorbs bone cells essentially weakening the skeletal system and making the body susceptible to fractures. Therefore, the Parathyroid hormone actively regulates Calcium and Phosphate levels to regulate Bone Homeostasis to function.

What biomarker/ diagnostic test is commonly decreased in Mary’s age demographic’s musculoskeletal system?

Bone Density is decreased

Mary’s Symptoms

Image of a women's organs showing symptoms of menopause affecting different parts of the body.
CC 1.0 Universal (CCO 1.0) https://upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Symptoms_of_menopause_%28vector%29.svg/640px-Symptoms_of_menopause_%28vector%29.svg.png

Treating Mary’s Menopause

Removing the ovaries stop the symptoms of Menopause. Mary is not ready to remove her ovaries, so she begins HRT.

Estrogen & Progesterone replacement therapy

  • Most common treatment for women 50+
  • Requires long-term commitment
  • Stabilizes mood, restores libido, prevents further bone reabsorption, relieves symptoms

License

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Multi-Course Case Studies in Health Sciences (Version 2) Copyright © 2021 by Laura Banks; Elita Partosoedarso; Manon Lemonde; Robert Balogh; Adam Cole; Mika Nonoyama; Otto Sanchez; Sarah West; Sarah Stokes; Syed Qadri; Robin Kay; Mary Chiu; and Lynn Zhu is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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