Androgens

Question 1

HRT

Answer 1

replaces oestrogen with or without progesterone to relieve symptoms of menopause

Question 2

Natural oestrogens

Answer 2

~ estrone
~ estradiol
~ estriol

Question 3

syntenic oestrogens

Answer 3

~ ethinylestradiol
~ mestranol

Question 4

Tibolone

Answer 4

combined HRT taken continuously
~ oestrogen, progesterone, weak androgen

Question 5

Vaginal atrophy

Answer 5

vaginal dryness
~ topical oestrogen, creams, tablets, rings

Question 6

HRT in women without a uterus

Answer 6

Oestrogen ALONE continuously

Question 7

HRT in women with a uterus

Answer 7

Oestrogen + Progesterone cyclically (or continuously to avoid withdrawal bleeding)

Question 8

when is combined HRT unsuitable

Answer 8

~ peri-menopause
~ <12 months after last periods = irregular bleeding

Question 9

HRT and surgery

Answer 9

~ STOP 4-6 weeks before elective surgery (risk of VTE, restart when fully mobile)

~ Non-elective surgery = parenteral anticoagulants (heparins & stockings)

Question 10

HRT and contraception

Answer 10

HRT does not provide contraception

<50y = fertile 2y after last period
~ low-oestrogen combined contraceptive

> 50y = fertile 1y after last period
~ condoms

Question 11

HRT SEs

Answer 11

cancers
~ ovarian, breast, cervical, endometrial

Coronary heart disease
~ if combined-HRT started 10y after menopause

Question 12

Reasons to stop HRT

Answer 12

~ VTE
~ STROKE
~ LIVER DYSFUNCTION
~ BP