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DU PA Gyn HRT
Duke PA Gyn Hormone Replacement Therapy
| Question | Answer |
|---|---|
| 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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