Estrogens

Question 1

What are the estrogen drugs?

Answer 1

• Conjugated equine estrogen (Premarin)
• Micronized Estradiol (Estrace)

Question 2

What are the indications for estrogen therapy?

Answer 2

Relief of menopause symptoms
1. Hot flashes
2. night sweats
3. vulvovaginal atrophy/dryness
4. Bone loss (treatment and prevention)

Low estrogen from hypogonadism

Question 3

What is length of treatment goal with estrogen only therapy?

Answer 3

< 5 years

Question 4

_______-_______ weeks should pass before adjusting dosing of estrogen therapy

Answer 4

6-8

Question 5

Only _____% of estrogens are unbound and biologically active

Answer 5

1-2

Question 6

true or false:

Orally administered estrogen therapy undergoes extensive first pass effect

Answer 6

True

Question 7

What are the monitoring considerations for estrogen therapy?

Answer 7

BP, Lipids, mammograms @ baseline and annually

Question 8

What are the absolute contraindications to estrogen-only therapy?

Answer 8

Intact uterus
Pregnancy
current/prior estrogen dependent cancers
DVT/VTE within a year
liver disease

Question 9

The most common drug interactions for estrogens are:

Answer 9

Anticoagulants
Tricyclic antidepressants
steroids
seizure medications

Question 10

ADR related to estrogen therapy can be severe. What are they?

Answer 10

Endometrial cancers
Thromboembolic events
* DVT
* Stroke
* MI