HRT

Question 1

What are the 4 types of HRT?

Answer 1

Unopposed oestrogen
Combined HRT
Cyclical regime
Continuous schedule

Question 2

What is unopposed oestrogen?

Answer 2

Provides oestrogen daily

Question 3

Advantages of unopposed oestrogen?

Answer 3

Used for women who have undergone early menopause due to hysterectomy
Can help prevent hot flashes

Question 4

Disadvantages of unopposed oestrogen?

Answer 4

Increased risk of endometrial (uterine) cancer
Increased risk of venous thrombosis
Increased breast tenderness and fluid retention

Question 5

Combined HRT info?

Answer 5

Provides oestrogen taken daily
Progestin taken either daily or only part time
Can be taken continuously or in cyclic regime

Question 6

Advantages of Combined HRT?

Answer 6

Reduces risk of endometrial cancer
Reduces risk of osteoporosis
Can help prevent vaginal dryness

Question 7

Disadvantages of combined HRT?

Answer 7

Increased risk of stroke

Increased breast tenderness and headaches

Question 8

What is cyclical regime of HRT?

Answer 8

Oestrogen and progestin taken for 3 weeks then stopped for 1 week when woman menstruates.
OR
Oestrogen taken continuously and progestin is taken for 10-14 days per month following which a woman has a withdrawal bleed.

Question 9

Advantages of a cyclical regime of HRT?

Answer 9

Lighter periods
Reduced risk of osteoporosis
Reduces vaginal dryness

Question 10

Disadvantages of cyclical regime of HRT?

Answer 10

Still have periods

Breast tenderness

Question 11

What is a continuous schedule of HRT?

Answer 11

Same hormones taken everyday of the month

Either in tablet form or skin patch, or under the skin implant

Question 12

Advantages of continuous schedule of HRT?

Answer 12

No withdrawal bleeds
Reduced mood swings
Can help prevent hot flushes

Question 13

Disadvantages of continuous schedule of HRT?

Answer 13

Skin patch needs replacing every 1-2 weeks

Increased risk of breast cancer

Question 14

Advantages of skin patches?

Answer 14

Convenient
No need to remember to take pills
No does and hormonal surges as continual steady release.
Less side effects

Question 15

What is used as an alternative to HRT?

Answer 15

Phytoestrogens

• Chemicals found naturally occurring in plants
• Have a chemical structure very similar to oestrogen
• So can bind to oestrogen receptors on cells.
• Some can be converted to oestrogen-like compounds by bacteria in the gut by hydrolysis reactions.

Question 16

Examples of phytoestrogens?

Answer 16

Isoflavones - found in soya beans and alfalfa

Lignans - found in cereal grains, most vegetables and fruits.