Chen - Women's Health Flashcards
Menopause Diagnosis
12 consecutive months of amenorrhea
Increased LH and FSH
Menopause Diagnosis
12 consecutive months of amenorrhea
Increased LH and FSH
postmenopause
time after the period stops
Premature menopause
occurs before age 40
due to hysterectomy, radiation, chemo
Indications for hormonal therapy in menopause
vasomotor symptoms
vulvovaginal atrophy
osteoporosis prevention
CI to hormonal treatment
bleeding pregnancy breast/endometrial cancers stroke liver disease thrombo disorder
Mono oral estrogens
premarin
menest
estrace
*tend to have more side effect
Who can have estrogen monotherapy
ONLY women WITHOUT a uterus
Oral hormonal combos
prempro angeliq jinteli activella mimvey prefest
Hormonal patches
menostar alora climara minivelle vivelle *who the f names this shit
Vaginal tablets
*only used for vaginal symptoms like dryness
vagifem
yuvafem
vaginal rings (and their difference)
Estring - smaller
Femring - bigger - requires a progesterone with it
Vaginal creams
*only for vaginal atrophy
estrace
premarin
WHI study findings for combo products
Increased risk of heart attack, stroke, thrombembolisms, breast cancer, dementia
Decreased risk of colorectal cancer, hip fractures
WHI study findings for estrogen mono
higher risk of stroke and embolism
lower risk of hip fractures
WHI study findings for age group
For least amount of risk, hormonal therapy should be started before age 60 or within 10 years of the last period
Continuous cyclic administration
daily estrogen + 12-14 days progesterone in a 28 day cycle
scheduled bleeding - good in recently menopausal women
HIGHER ENDOMETRIAL CANCER RISK
premphase, combipatch
Continuous Long Cycle Administration - rare
estrogen daily + 12-14 days progesterone every other month
HIGHER ENDOMETRIAL CANCER RISK
Continuous Combined Administration - most common
estrogen + progesterone daily
best endometrial protection
no bleeding - for women >2 years postmenopause
Prempro, jinteli, angeliq, activella, mimvey, combipatch, climara pro
Intermittent Combined Administration
Estrogen daily + progesterone 3 days on and 3 days off
good if having SEs from daily progesterone
unknown endometrial risk
prefest
Duavee
estrogen + SERM bone agonist - helps with osteoporosis breast + uterus antagonist - cancer prevention treats vasomotor can increase CV risk less hormonal symptoms
Non-hormonal Vasomotor Treatment
SSRIs : paroxetine, citalopram, escitalopram
SNRIS: ven and desvenlafaxine
Osphena
treats dyspareunia - painful sex due to vaginal dryness
causes hot flashes
same CIs of estrogens
intrarosa
treats dyspareunia
very expensive
