25-Hormone Therapy

Question 1

What are the risk factors for osteoporosis?

Answer 1

Reduced weight for height
Family history 
Early menopause or oophorectomy
Low calcium intake
Cigarette smoking
Nulliparity
High alcohol/ caffeine intake

Question 2

What is the duration of therapy?

Answer 2

4 weeks required to determine effectiveness in alleviating vasomotor symptoms
Short term is 2-4 years

Question 3

What are the risk associated with therapy?

Answer 3

Increase breast cancer with equine estrogen + MPA after as little as 2 years
Increase risk of venous thromboembolism in 1st year
Coronary events within 1st year of use
Increase stroke during 2nd year

Question 4

When do use estrogen alone or with progesterone?

Answer 4

Adjunctive progesterone therapy is required if the patient has an intact uterus
Unopposed estrogen increases risk of endometrial adenocarcinoma
Estrogen only did not show an increase in breast cancer

Question 5

What are the benefits of therapy?

Answer 5

Mostly for symptoms
Vasomotor symptoms- alleviation of hot flashes and night sweats
Estrogen is effective for treatment of vaginal dryness
High dise androgen in surgically menopause improves desire
Increase collagen and reduce wrinkles
Reduce UTI

Question 6

What are the risks of therapy?

Answer 6

Breast cancer( with progesterone)
Thromboembolic disease
Stroke
Pancreatitis and cholecystitis

Question 7

What are the factors that are not affected by therapy?

Answer 7

Weight
Insulin resistance
Osteoarthritis- no role in prevention or treatment

Question 8

What are the absolute therapy to estrogen therapy?

Answer 8

Known or suspected breast cancer
Estrogen dependent neoplasia
Undiagnosed abnormal genital bleeding
Thromboembolic disease
Hepatic disease

Question 9

What are the adverse effects of estrogen therapy?

Answer 9

Breast tenderness
Bloating
Edema
Headaches