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Understanding The Pathophysiology Of Vasomotor Symptoms Assignment

Understanding The Pathophysiology Of Vasomotor Symptoms Assignment

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Obstetric SOAP Note
S. Client X is a 49-year-old woman who came to the health facility presenting perimenopausal symptoms, including night sweats, anxiety and hot flushes. She states that the above symptoms had commenced over the last year, worsening one week before her monthly periods. She reports she has regular menses happening every 28 days, which is very light and short. She states she usually changes one pad daily, lasting three to five days. She reports she was done hysteroscopy endometrial ablation in 2019. She denies smoking or use of illegal drugs. She takes two bottles of alcohol occasionally. She refuses histories of PAPs and sexually transmitted diseases. Client X also denies any past medical history or neither family history of uterine cancer, allergic to PCN, breast cancer and ovarian cancers. Understanding The Pathophysiology Of Vasomotor Symptoms Assignment

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O. general appearance: client X appears mildly anxious, not obese, alert and oriented to time, place and person. Not in distress.
Vital signs: Temp 94.7, wt. 270lbs, Ht 73’, Bp. 123/76mmHg. HR 76b/min.
Skin: warm, pink and dry. No suspicious lesions, nevi or masses were noted.
Neck; bilaterally symmetrical in shape. In impalpable lymphadenopathy, the thyroid gland is neither palpable nor mass masses or lumps.
Respiratory: CTAB, chest wall moves up and down with each breath, non-laboured breathing. No dyspnea
Breast examination: bilaterally symmetrical in shape and size. Absence of the dimpling of the breast bilaterally, no lesions around both breasts, no masses noted on palpation, and no discharge, inversions or lesions around the nipples. The lymph nodes around the axilla are unpalpable. No masses around the infra and supraclavicular region.
Cardiovascular: soft, protuberant, non-tender and non-tender without signs of guarding, rigidity or rebound tenderness, unpalpable hepatosplenomegaly. Dullness of the liver n percussion.
Extremities- normal peripheral circulation, capillary refill less than two seconds. No evidence of clubbed fingers or cyanosis.
Pelvic examination: external genitalia is filled with hair distribution of a typical female pattern, no valvular erythema or lesions around the labia vaginal walls are pink, moist, reggae present .no prolapse noted. On speculum examination, the cervix has no lesions, discharge, or signs of bleeding or polyps. Bimanual: suboptimal due to body habitus, negative CMT. The uterus is midline, soft, mobile and non-tender. No adnexa tenderness of masses around the uterus.
A: Perimenopausal Vasomotor Symptoms. Understanding The Pathophysiology Of Vasomotor Symptoms Assignment
Vasomotor symptoms related to menopause are also called hot flashes and night sweats. Most women sought to seek treated mostly during menopause moments. Vasomotor menopausal symptoms are a form of temperature dysfunction due to changes in gonadal hormones. Due to the limitations post-menopause period, hormones such as estrogen alter multiple components in regulating and maintaining temperature homeostasis. Vasomotor perimenopausal symptoms demonstrate themselves as hot flushes and night sweats (Deecher & Dorries, 2007). The limitation of the gonadal hormones, mainly estrogen, is responsible for the excessive heat losses. Vasomotor premenopausal symptoms are related to decreased estrogen associated with menopause, as evidenced by vagina dryness. It is a common cause of dyspareunia in postmenopausal women.
Differential diagnosis.
The differential diagnosis of hot flushes associated with the postmenopausal period includes the presence of carcinoid tumours, hyperthyroidism, acromegaly, pheochromocytoma, and impairment of the thyroid medulla by carcinoma and postmenopausal depression. Understanding The Pathophysiology Of Vasomotor Symptoms Assignment
P. The treatment of postmenopausal vasomotor symptoms is managed by pharmacologic therapy. Drugs that prove effective in managing VSM include venlafaxine hydrochloride, depo leuprolide, tamoxifen, calcium channel blockers, tricyclic antidepressants, clomiphene and monoamine oxidase inhibitors. If symptoms do not resolve or worsen, consideration of hormone replacement therapy such as progesterone since the uterus is intact, gabapentin Vistaril and clonidine is then considered.
Non-pharmacologic therapy used in the management of VSM includes avoiding personal triggers such as taking hot drinks, caffeine, alcohol intake, and stress and encouraging weight loss significantly helps reduce VSM.

References
Deecher, D. C., & Dorries, K. (2007). Understanding the pathophysiology of vasomotor symptoms (hot flushes and night sweats) that occur in perimenopause, menopause, and post menopause life stages. Archives of women’s mental health, 10(6), 247–257. https://doi.org/10.1007/s00737-007-0209-5 Understanding The Pathophysiology Of Vasomotor Symptoms Assignment

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