Hormone Therapy Flashcards
(27 cards)
What is the definition of menopause?
12 consecutive months without a menstrual period
What is the average age of menopause?
51 years
What is the perimenopause age?
42 and 56
What are the replacement therapies used for menopause?
Hormone Replacement Therapy (HRT)
Hormone Therapy (HT)
Estrogen-only replacement therapy (ERT)
What is estrogen derived from?
Androgenic precursors by means of aromatization
What three steroids do the ovaries produce at menarche?
Estrogen, progestin and androgen
What is 17-beta estradiol?
it is the major form of estrogen produced in young women and the most active
What derivative of estradiol after menopause is more abundant?
Estrone
Where are alpha receptors more present?
Breast, endometrium and ovary
Where are beta receptors more present?
Bone, lung and kidney
What effects do estrogen have on the body?
Primary and secondary sex characteristics, physiological processes related to reproduction
Maintains bone density and skin integrity
Impacts blood clotting and stability of thermoregulatory system
What are the therapeutic uses of estrogens?
Hormone therapy after menopause
Female hypogonadism
What are the routes of administration of estrogen?
Oral
Transdermal (patches, gels, sprays, lotions)
Intravaginal (suppositories, creams, rings)
Parental
What route of administration is not preferred due to adverse effects?
Oral
What are adverse effects of estrogen?
Endometrial hyperplasia and carcinoma
Breast Cancer
Ovarian Cancer
What are favorable actions of estrogen?
Positive effect on bone mass
Favorable cholesterol levels
Reduces urogenital atrophy
Relief vasomotor symptoms of menopause
What is the role of progestin?
Thickening of the endometrial lining and preparation of the uterus for pregnancy, thickening of the cervical mucus, and breast development
What are the actions of progestin outside of the reproductive system?
Increasing fat deposition, increasing basal insulin levels, increasing body temperature, and other effects
What are the adverse effects of progestin?
Teratogenic effects
Breast Cancer
Breast tenderness
Depression
What are the indications of hormone therapy?
To relieve vasomotor symptoms
To improve urogenital symptoms
To prevent osteoporosis
What are contrainidications of hormone therapy?
Hx of breast cancer or endometrial
Severe active liver disease
Hypertriglyceridemia
Thromboembolic disorders
Undiagnosed vaginal bleeding
Endometriosis
Fibroids
What are the rationales of prescribing HT?
use the lowest dose and shortest time frame
individualize choice of drug and dose based on woman’s risk profile
Monitor at least annually for risk profile, AEs , continues need for therapy
Only start at time of menopause
Why can’t HT be prescribed after the first five years of menopause?
Adverse effect risk increases if started more than 5 years after the onset of
A progestin is included in regimens for HRT to prevent which adverse effect?
Endometrial cancer
