sex hormones

Question 1

what is the purpose of Hormone replacement therapy (HRT)

Answer 1

HRT= small doses of an oestrogen (together with a progesterone in women with a uterus)

used to relieve symptoms of menopause such as: vaginal atrophy (thinning, drying and inflammation of the vaginal walls) or vasomotor instability (hot flushes).

note HRT should only be started is symptoms are significantly affecting quality of life. HRT can be used for menopausal osteoporosis but this is rare as there are other alternatives

Question 2

what are the risks associated with Hormone replacement therapy (HRT)

Answer 2

HRT increases risk of:

• venous thromboembolism
• stroke
• endometrial cancer (reduced by a progestogen)
• breast + ovarian cancer
• coronary heart disease in women who start combined HRT more than 10 years after menopause

Question 3

what is the difference between Hormone replacement therapy (HRT) in women with a uterus and in women without a uterus

Answer 3

women with a uterus: oestrogen alone is suitable

women without a uterus: needs a preparation with oestrogen + progestogen

Question 4

when should Hormone replacement therapy (HRT) be stopped

Answer 4

if any of the following occur:

• sudden severe chest pain (even if not radiating to left arm)
• sudden breathlessness (or cough with blood-stained sputum)
• unexplained swelling or severe pain in calf of one leg
• severe stomach pain
• serious neurological effects including unusual severe, prolonged headache, vision + hearing disturbances, fainting attacks, first unexplained epileptic seizure, very marked numbness suddenly affecting one side or one part of body
• hepatitis, jaundice, liver enlargement
• blood pressure above systolic 160 mmHg or diastolic 95 mmHg
• prolonged immobility after surgery or leg injury
• detection of a risk factor which contra-indicates treatment.

Question 5

what are the uses of finasteride

Answer 5

• enlarged prostate

- A low strength of finasteride is licensed for treating male-pattern baldness in men

Question 6

what is used for replacement therapy in men

Answer 6

Intramuscular depot preparations of testosterone esters

note testosterone is an androgen. Androgens cause masculinisation

Question 7

what is Cyproterone acetate used for in men

Answer 7

treatment of severe hypersexuality and sexual deviation in the male

Question 8

what is the rare side effect associated with men taking finasteride

Answer 8

rare reports of depression and suicidal thoughts

Patients should be advised to stop finasteride immediately and inform a healthcare professional if they develop depression.

Question 9

why should men taking finasteride use a condom is their partner is pregnant or likely to become pregnant

Answer 9

because Finasteride is excreted in semen

Question 10

what precautions do women of childbearing age need to consider when handling finasteride

Answer 10

Women of childbearing potential should avoid handling crushed or broken tablets of finasteride.

Question 11

what should a male patient do if they discover any changes in breast tissue such as lumps, pain, or nipple discharge whilst taking finasteride

Answer 11

report to doctor asap. Cases of male breast cancer have been reported whilst taking finasteride