Estrogen: HRT

Question 1

Therapeutic Class

Answer 1

Hormone

Question 2

Examples

Answer 2

conjugated estrogens (Cenestin, Enjuvia, Premarin)

Question 3

Mechanism of Action

Answer 3

replacement for female sex hormones

Question 4

Actions and Uses

Answer 4

Mixture of different natural estrogens: Conjugated estrogen A (Cenestin) & conjugated estrogen B (Enjuvia) contain a mixture of 9–10 different synthetic plant estrogens.
Treat abnormal uterine bleeding due to hormonal imbalance
Treat moderate-severe symptoms caused by diminished estrogen secretion by ovaries. (post-menopausal)
Treatment of female hypogonadism & after oophorectomy.
Topical may benefit vulvar & vaginal atrophy.
Palliative treatment of prostate cancer
Increase bone density, reduce LDL, lower CAD & Colon Ca risk

Question 5

Adverse Effects

Answer 5

Nausea, fluid retention, edema, breast tenderness, abdominal cramps, bloating, acute pancreatitis, appetite changes, acne, depression, decreased libido, headache, fatigue, nervousness, weight gain

Question 6

Black Box Warning

Answer 6

When used alone, associated with higher risk of endometrial cancer in postmenopausal women. Also increase risk of stroke, D V T, M I, & pulmonary emboli
Adding progestin may exert a protective effect by lowering the risk of uterine cancer
Estrogens should not be used to prevent cardiovascular disease or to treat dementia.

Question 7

Contraindications

Answer 7

Estrogen-dependent tumor/carcinoma, caution if history of thromboembolism

Question 8

Preg Cat

Answer 8

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