HRT

Question 1

What are oestrogens necessary for?

Answer 1

The development of secondary sexual characteristics

Question 2

What activities does Tibolone have?

Answer 2

Oestrogenic, progesterogenic, and weak androgenic activity

Question 3

For what conditions is oestrogen therapy given?

Answer 3

A wide range of conditions

Question 4

Why is progesterone added in hormone replacement therapy (HRT)?

Answer 4

To reduce the risk of endometrial cancer

Question 5

What menopausal symptoms are alleviated by small doses of oestrogen?

Answer 5

Vaginal atrophy, hot flushes, skin ageing, bone loss, reduced muscle mass, dryness

Question 6

When is progesterone not needed to be given?

Answer 6

When Tibolone is given

Question 7

What does progesterone combine?

Answer 7

Oestrogenic and progesterogenic activity

Question 8

What is defined as early menopause?

Answer 8

Less than 45 years

Question 9

What is considered normal menopause?

Answer 9

50 years and over

Question 10

What alternatives to HRT should be given if osteoporosis is the main concern?

Answer 10

Alternatives to HRT

Question 11

What is Clonidine used for?

Answer 11

To reduce vasomotor symptoms in women who cannot take oestrogen

Question 12

What are some risks associated with HRT?

Answer 12

VTE, stroke, breast and ovarian cancer

Question 13

When does CVD risk increase in women regarding HRT?

Answer 13

10 years after menopause has started

Question 14

What does the MHRA advise about prescribing HRT?

Answer 14

It should only be prescribed to relieve postmenopausal symptoms affecting quality of life and reviewed regularly

Question 15

What is important to ensure when prescribing HRT?

Answer 15

Minimum effective dose is used

Question 16

Does HRT protect against CHD?

Answer 16

No

Question 17

What is the increased risk of breast cancer after one year of HRT use?

Answer 17

Increased risk of breast cancer

Question 18

Which type of HRT is associated with a higher risk of breast cancer?

Answer 18

Combined pills

Question 19

What happens to the risk associated with HRT the longer it is used?

Answer 19

The more the risk increases

Question 20

Are vaginal preparations associated with breast cancer risk?

Answer 20

No

Question 21

What increases the risk of endometrial cancer?

Answer 21

Dose and duration of HRT

Question 22

How does progesterone affect the risk of endometrial cancer?

Answer 22

Reduces the risk

Question 23

What is the association of long-term use of combined HRT or estrogen-only HRT?

Answer 23

Small increase of ovarian cancer risk

Question 24

What does combined or estrogen-only HRT increase the risk of?

Answer 24

VTE and stroke

Question 25

What should be done before major surgery under general anaesthetic if on HRT?

Answer 25

Stop HRT four to six weeks before surgery and restart only after full mobilisation

Question 26

What prophylaxis is advised if HRT is continued during major surgery?

Answer 26

Unfractionated or LMWH and graduated compression hosiery

Question 27

What are reasons to stop HRT?

Answer 27

Sudden severe chest pain, sudden breathlessness, unexplained swelling, hepatitis, jaundice, prolonged immobility after surgery

Question 28

What is Ethinyl estradiol used for?

Answer 28

Short-term treatment of symptoms of oestrogen deficiency, osteoprophylaxis, treatment of hypogonadism in females, and menstrual disorders

Question 29

What is Reloxifene used for?

Answer 29

Treatment and prevention of postmenopausal osteoporosis

Question 30

What can intermittent ulipristal acetate be used to treat?

Answer 30

Moderate to severe symptoms of uterine fibroids and as an emergency hormonal contraceptive