Duke PA Gyn Hormone Replacement Therapy
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| If a uterus is present and you are putting a woman on hormone replacement therapy always include | Progestin
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| If you are putting a woman on hormone replacement and she has had a hysterectomy __ is not essential | Progesterone
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| Hormones given parenterally may offer more __ ratio | Physiologic estradiol to estrone (estradiol>estrone)
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| What route of hormone replacement is very rarely used (not very patient friendly) | Injection
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| Prometrium is contraindicated in anyone with a __ allergy | Peanut
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| Why is testosterone given to postmenopausal women, what does it improve | Libido, sense of well-being, energy
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| What should be monitored within several weeks of beginning HRT | Resolution of menopausal symptoms, possible adverse SE’s, BP and Wt, assessment of vaginal bleeding, compliance
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| Women should be on the lowest hormone dose that controls symptoms and re-evaluated every __ for possible taper or discontinuation | 3-6
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| When HRT is tapered what is the most common withdrawal vasomotor symptom | Hot flashes
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| What is the purpose of HRT (indications) | Treatment of moderate to severe vasomotor symptoms associated with the menopause, treatment of moderate to severe symptoms of vulvar and vaginal atrophy associated with the menopause, prevention of postmenopausal osteoporosis
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| Estrogens and progestins should not be used for the prevention of __ | Cardiovascular disease
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| What are the absolute contraindications for estrogen | Breast cancer, estrogen-dependent neoplasia, undiagnosed abnormal genital bleeding, thromboembolic disease, pregnancy, porphyria, active liver disease
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| Benefits of HRT | Alleviation of vasomotor symptoms, relief of vaginal dryness/atrophy, raised HDL/lowered LDL, alleviation of mood swings and fatigue, reduced risk of fractures, reduced risk of colon cancer, reduced risk of diabetes
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| Risks associated with HRT | Breast cancer, endometrial cancer, thromboembolic events, increased risk of dementia
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| Unopposed estrogen can lead to | Endometrial cancer
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| If your patient doesn’t want to use HRT what are some other options to treat menopausal symptoms | Herbal/complementary, bio-identical estrogens, antidepressants, neuroendocrine agents, lifestyle and behavioral modifications
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| Herbal therapies that may be used in the treatment of menopausal symptoms | Phytoestrogens (soy isoflavones, red clover), black cohosh, dong quai, evening primrose oil, ginseng, wild yam, vitamin E
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| Most studied herb for menopausal symptoms, was show to be somewhat effective for the treatment of hot flashes | Black Cohosh (Remifemin)
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| Gabapentin has shown some effect on __ | Hot flashes
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| __ has the highest percent of elemental calcium | Calcium carbonate
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