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Elaine E. Jolly, O.C., M.D., F.R.C.S.(C.)

GYNECOLOGIC ISSUES IN THE LATE POST MENOPAUSAL WOMAN. Elaine E. Jolly, O.C., M.D., F.R.C.S.(C.) Medical Director Shirley E. Greenberg Women’s Health Centre Professor of Obstetrics and Gynaecology University of Ottawa. GYNECOLOGIC ISSUES in the “ Geripause ”. Introduction

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Elaine E. Jolly, O.C., M.D., F.R.C.S.(C.)

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  1. GYNECOLOGIC ISSUES IN THE LATE POST MENOPAUSAL WOMAN Elaine E. Jolly, O.C., M.D., F.R.C.S.(C.) Medical Director Shirley E. Greenberg Women’s Health Centre Professor of Obstetrics and Gynaecology University of Ottawa

  2. GYNECOLOGIC ISSUES in the “Geripause” • Introduction • Life Threatening Disorders: Cancers • Most Common Gynecologic problems • Summary

  3. Physiology of the “Geripause” Decreased Estrogen Causes Progressive Atrophy • Thinning of vulvar tissue • Thinning, greying, loss of pubic hair • Diminution of labia minora • Presence of petechia • Vaginal walls are atrophic and pale • Shortening and narrowing of vagina • Atrophy of cervix / cervical stenosis • Decreased uterine size • Atrophic endometrium • Fibrous myometrium • Ovarian senescense

  4. Gynecologic Examination in the Elderly Female • Abdominal/inguinal exam • Vulvar/perineal inspection • Inspection of Vagina/Vault • Cervix (stenosis), Pap Smear (brush) • Bimanual exam (uterus/adnexa) • Pelvirectal exam Gently, slowly, sensitively Be innovative and accommodating Respect patient’s modesty Warm hands – warm instruments

  5. Gynecologic Issues • Life Threatening Disorders • Quality of Life Issues

  6. Life Threatening Disorders • Ovarian Cancer • Uterine Cancer • Cervical Cancer • Vulvar Cancer

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