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Duke PA Gyn Hormone Replacement Therapy

If a uterus is present and you are putting a woman on hormone replacement therapy always include Progestin
If you are putting a woman on hormone replacement and she has had a hysterectomy __ is not essential Progesterone
Hormones given parenterally may offer more __ ratio Physiologic estradiol to estrone (estradiol>estrone)
What route of hormone replacement is very rarely used (not very patient friendly) Injection
Prometrium is contraindicated in anyone with a __ allergy Peanut
Why is testosterone given to postmenopausal women, what does it improve Libido, sense of well-being, energy
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
Women should be on the lowest hormone dose that controls symptoms and re-evaluated every __ for possible taper or discontinuation 3-6
When HRT is tapered what is the most common withdrawal vasomotor symptom Hot flashes
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
Estrogens and progestins should not be used for the prevention of __ Cardiovascular disease
What are the absolute contraindications for estrogen Breast cancer, estrogen-dependent neoplasia, undiagnosed abnormal genital bleeding, thromboembolic disease, pregnancy, porphyria, active liver disease
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
Risks associated with HRT Breast cancer, endometrial cancer, thromboembolic events, increased risk of dementia
Unopposed estrogen can lead to Endometrial cancer
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
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
Most studied herb for menopausal symptoms, was show to be somewhat effective for the treatment of hot flashes Black Cohosh (Remifemin)
Gabapentin has shown some effect on __ Hot flashes
__ has the highest percent of elemental calcium Calcium carbonate
Created by: bwyche
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