Hormone Replacement Therapy

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Author:
capnhue
ID:
143061
Filename:
Hormone Replacement Therapy
Updated:
2012-04-03 23:02:47
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Regis University
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Description:
Hormone Replacement Therapy
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  1. Contraindications for HRT
    • abnormal vaginal bleeding
    • presence/history of hormone-dependant malignancy
    • active/history of VTE
    • active endometriosis
    • severe liver disease
    • active/recent (1yr) thromboembolic disease (MI, stroke)
    • breast cancer
    • endometrial cancer
    • hypersensitivity to estrogen/progestin therapy
  2. Phytoestrogen reduce/protect
    • reduce menopausal symptoms
    • protect against CAD
    • breast cancer
    • osteoporosis
  3. Black Cohosh
    • Rhizomes: contain formononetin (a phytoestrogen) & provide estrogenic activity
    • triterpenoid 27-deoxyactein: estrogenic activity
    • isoferulic acid: anti-inflammatory & decrease muscle spasm
    • salicyclic acid: antiinflammatory & analgesic prperties
    • cimicifugoside: affect hypothalamus-pituitary function
  4. Menopause definition
    • defined as the time of the last menstrual period
    • average age of menopause 51
    • menopause occurs 2yrs earlier if you smoke
  5. Perimenopause definition
    • begins when menstrual cycle irregularity and continues until 12 months of amenorrhea (no bleeding)
    • begins abour 4yrs prior to menopause
  6. Postmenopause definition
    women who have not experienced menstrual bleeding for at least 12 months
  7. Estrogen produced where in menopausal woman???
    • thecal cells
    • liver
    • adrenal glands
    • *estrone levles increase and estradiol levels decrease
  8. Menopausal sex characteristics
    • loss of body hair
    • reduction in skin elasticity
    • reduce in subcutaneous fat (decreasing breast size)
    • vaginal dryness
    • urinary stress incontinence and urgency (caused by urogenital atrophy)
    • nocturia
    • UTI
  9. vasomotor instability (symptoms)
    • hot flashes
    • night sweats
    • dizziness
    • headaches
    • vasomotor symptoms lead to irritability, anxiety, depression
    • occur most in obese and smokers
  10. Long-term complications menopausal woman
    • cardiovascular disease (leading cause of death in postmenopausal woman)
    • osteoporosis
    • vision loss
    • cognitive impairment
  11. Trigger vasomotor symptoms
    • hot weather
    • caffeine
    • alcohol ingestion
    • intake of spicy foods
    • hot drinks
  12. Progestins used in HRT include:
    • medroxyprogesterone acetate
    • micronized progesterone
    • norethindrone acetate
    • norgestrel
    • levonorgestrel
  13. Primary estrogens used in HRT include:
    • conjugated equine estrogens (CEE)
    • endogenous estrogen (estradiol acetate)
  14. Phytoestrogens
    • made from beans, seeds, grains, soybean has high content of phytoestrogens
    • benefical effects: postmenopausal symptoms, cardiovascular disease, prevents osteoporosis
    • low doses: act like estrogen
    • high doses: block estrogen
  15. Alternative medications for menopause
    • venlafaxine
    • paroxetine
    • clonidine
    • gabapentin
    • megestrol acetate
    • black cohosh
  16. Black Cohosh adverse effects
    • can cause acute hepatitis
    • need baseline and periodic LFT

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