1. SC300 Unit Five Alissa Rennie ARennie@kaplan.edu AIM: alissarennie1@kaplan.edu

2. Agenda 1.Menopause -History -Symptoms -Treatments a)Lifestyle changes b)Prescription c)Nonprescription 2.Soy 3.Smoking 4.Q&A

3. Seminar Preparation Please remember that the “pre-seminar” assignment should be done before we meet for the seminar For example tonight you should have prepared the following: Come to Seminar prepared to discuss the case of your second cousin Tilly, a 53-year-old woman who comes to you concerned about menopause. -What treatments exist for menopause and how safe and effective are they? -What are some of the drawbacks to these treatments? -If Tilly has been a smoker all her life, how might this alter her transition through menopause? -Do some research on your own to learn about why, among Japanese women, hot flashes are very rare. Why do you think this might be the case?

4. History “Menopause is not a dangerous time or experience for the majority of women, any more than puberty is….” ~Dr. Andrew F. Currier, 1897 “…a large proportion of women go through menopause with scarcely a ripple and need no medical treatment whatsoever.” ~Dr. Emil Novak, 1922

5. What is Menopause Menopause is a re-equilibration of reproductive hormones that women usually experience when they are in their 40s, 50s, and 60s

6. What are hormones? Hormones are part of your endocrine system A hormone is a chemical substance made by an organ like the thyroid gland or ovary. In a woman’s body during the menopause transition, the months or years right before menopause (her final menstrual period), levels of several hormones, including estrogen and progesterone, go up and down irregularly.

7. The endocrine system Hormones work with the nervous system, reproductive system, kidneys, gut, liver and fat to help maintain and control: body energy levels reproduction growth and development homeostasis responses to surroundings, stress, and injury

8. Symptoms and evaluation Episodes of sweating or hot flushes Heart discomfort Sleep problems Depressive mood, irritability, or anxiety Physical or mental exhaustion Sexual problems Bladder problems Dryness of vagina, skin, or hair Joint or muscular discomfort

9. Why does menopause exist? Minimize Reproductive Competition Between Females In A Family

10. Not just for the ladies…. Male aging syndrome As men age, they produce less testosterone than they did during their teen years and early adulthood

11. Treatments: lifestyle changes Image credit: Microsoft Clip Art

12. Treatments: prescription ProCon Hormone therapy (local or systemic): estrogen, progestogen, or combinations Decrease hot flashes Relieve vaginal dryness Relieve some urinary symptoms Prevent osteoporosis Increased risk of developing breast and uterine cancers; heart disease, stroke, and pulmonary embolism; and dementia Low-dose antidepressants Decrease hot flashes Relieve some mood symptoms Side effects may include sexual dysfunction, anxiety, headache, nausea, insomnia or drowsiness, dry mouth, decreased appetite, or constipation Anti-seizure medicationsDecrease hot flashes Side effects may include fatigue, dizziness, rash, heart palpitations, swelling, and drowsiness, but generally decrease over time (weeks) Anti-hypertensive (blood pressure) medications Decrease hot flashes Unpleasant side effects including dry mouth, drowsiness, or insomnia are common BisphosphenatesPrevent or treat osteoporosis Side effects may include damage to the esophagus and muscle pain; long-term use can lead to brittle bones (quantity over quality) Selective estrogen receptor modulators Prevent or treat osteoporosisIncreased risk of blood clots, hot flashes, nausea, and leg cramps

13. Treatments: nonprescription ProCon Black cohosh (Actaea racemosa, Cimicifuga racemosa, Remifemin) Decrease hot flashes Relieve some mood symptoms Relieve vaginal dryness Reduce sleep disturbances Increased risk of liver problems Dong Quai (Angelica sinensis) Decrease hot flashes Relieve some mood symptoms Relieve vaginal dryness Increased risk of bleeding complications Ginseng or Ginkgo (Panax ginseng or Panax quinquefolius) Relieve some mood symptoms Reduce sleep disturbances Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses Chaste Berry (Vitex agnus castus) Decrease hot flashes Relieve some mood symptoms Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses. Passion flower (Passiflora incarnata) Relieve some mood symptoms Reduce sleep disturbances Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses.

14. Smoking Image credit: Microsoft Clip Art

15. Soy

16. Unit Five – Assignment/Quiz Unit Five Project is a lab-simulation -Do the simulation and keep track of your results -Follow the directions under Unit Five – Project

17. Unit Five – Assignment/Quiz Write down answers to the questions on the list while going through the demonstration but do not turn them in, they are for your benefit. After going through the lab/demo you must complete the Quiz to receive full credit.

18. Assingment/Quiz Concept: Thermodynamics Nature has a direction – what does that mean?

19. Assingment/Quiz Concept: Thermodynamics Nature has a direction – what does that mean? Directionality can be traced to the behavior of atoms and molecules Atoms never sit still – they are always moving (kinetic energy)

20. Heat and Temperature Heat flow via conduction, radiation or convection Heat flows from warm objects to cold objects. Entropy (disorder) of a system tends to increase over time.

21. Discussion Board – Unit Five Discussion at Natural Disasters, particularly Hurricane Katrina Government site that gives history of Katrina, recovery efforts and disaster preparedness

22. Weather

23. Air Mass Types

24. Tornadoes

25. Discussion Board – Unit Five What kinds of imbalances might affect your region (Note: Please do not discuss earthquakes, as they were discussed in last week's Discussion.) What people in your area can do to prepare for them or prevent them. Give some specific examples of weather incidents that occurred in your area in the past and discuss how those were handled. What major natural disasters of the past are most similar to one that might affect your area? Explain. Compare your own area's similarity to New Orleans: what similarities and differences exist between the areas? Explain how you think a massive rescue and recovery effort might play out differently in your area, versus how it played out, and continues to, in post-Katrina New Orleans.

26. Discussion Board - Content Discussion Questions provide a forum for students to ask questions and answer important questions about the course material. The Discussion Questions also allow students to receive feedback from the instructor and other students in the class. A Discussion Question grade will be posted to the grade sheet for each Unit. Content: 1. Answer the discussion question(s) completely 2. Responses must make some informed reference(s) to the lesson material (properly cited and referenced, of course) 3. Writing is clear with only minor mistakes in grammar, style, or punctuation that do not affect readability 4. Be polite and respectful. No yelling…please.

27. Discussion Board - Participation 1. Contribute meaningfully (substantially) on at least three days 2. Respond to at least two other people, in addition to answering the discussion question(s) completely 3. Responses must advance the discussion (If you wait to participate on the last day of the week, there is no way to advance the discussion as it is over!)

28. Image credits: Microsoft Clip Art