8: Recommendations for HT

Question 1

T/F HT should be individualized, be based on the woman’s health and personal risk factors, and take into account the woman’s quality of life priorities.

Answer 1

True

Question 2

T/F HT is indicated for the purpose of preventing CVD.

Answer 2

False. HT is not indicated for the sole purpose of preventing CVD.

Question 3

T/F Beginning HT in women aged 50 to 59 years or within 5 years of menopause to treat menopause-related symptoms should not increase CHD risk.

Answer 3

False. Beginning HT in women aged 50 to 59 years or within TEN years of menopause to treat menopause-related symptoms should not increase CHD risk. A growing body of evidence suggests that beginning ET during this time may decrease CHD risk.

Question 4

The recommended duration of therapy differs for ET versus EPT. Due to the established risk for breast cancer with EPT, therapy should be limited to _____ years. More flexibility with a longer duration of ET could be considered in the absence of adverse effects or known risk factors due to the more favorable safety profile of ET.

Answer 4

3 to 5 years

Question 5

T/F EPT is the most effective treatment for vulvar and vaginal atrophy.

Answer 5

False. ET is the most effective treatment for vulvar and vaginal atrophy.

Question 6

Low-dose, local _____ is recommended when only vaginal symptoms are present.

Answer 6

Low-dose, local ET is recommended when only vaginal symptoms are present.

Question 7

T/F Women who are appropriate candidates for HT and have undergone premature or early menopause can use HT at least until the median age of menopause (age 52). Longer duration of therapy may be considered based on need for ongoing symptom management.

Answer 7

True

Question 8

T/F Since the WHI did not reveal an increased risk for breast cancer with ET, the use of ET in breast cancer survivors is permissible.

Answer 8

False. Despite the fact that the WHI did not reveal an increased risk for breast cancer with ET, safety data are lacking to support the use of ET in breast cancer survivors.

Question 9

_____ and _____ ET have been associated with a lower risk for VTE and stroke when compared to standard doses of oral estrogen, but RCTs are still needed to corroborate this relationship.

Answer 9

TRANSDERMAL and LOW-DOSE ORAL ET have been associated with a lower risk for VTE and stroke when compared to standard doses of oral estrogen, but RCTs are still needed to corroborate this relationship.

Question 10

T/F HT is recommended for prevention of cognitive aging or dementia.

Answer 10

False. HT is NOT recommended for prevention of cognitive aging or dementia.

Question 11

All women with an intact uterus receiving systemic estrogen should either receive systemic progestogen or _____ to decrease the risk of endometrial carcinoma.

Answer 11

All women with an intact uterus receiving systemic estrogen should either receive systemic progestogen or HAVE A LNG-IUD PLACED to decrease the risk of endometrial carcinoma.