Gynae HRT and menopause Flashcards
What does HRT increase the risk of?
- VTE
- Breast cancer
- Endometrial cancer
- Stroke
- CAD
What does HRT decrease the risk of?
- Colorectal cancer
- Osteoporosis + fractures
What is the purpose of given progesterones as part of HRT?
To prevent endometrial hyperplasia and endometrial cancer secondary to “unopposed” oestrogen.
Who can have oestrogen only HRT?
Women without a uterus
Who should have cyclical HRT?
Women that still have periods
Who should have continuous combined HRT?
Postmenopausal women with a uterus and more than 12 months without periods if >50 or 24 months without periods if <50
What medication can be used for vasomotor symptoms of menopause when HRT is contraindicated?
Clonidine
What are side effects of clonidine? What can sudden withdrawal result in?
- Dry mouth, headaches, dizziness and fatigue
- Blood pressure and agitation
What does clonidine act as an agonist of?
Alpha-2 adrenergic receptors and imidazoline receptors in the brain
When is the patch indicated for HRT over oral treatment?
In women with increase VTE risk, CVD or headaches
What are the two options for delivering systemic oestrogen?
- Transdermal (patch/gel)
- Oral (tablets)
When can you switch from cyclical to combined HRT?
- After 12 months of cyclical HRT if >50
- After 24 months of cyclical HRT if <50
What are three options for delivering progesterone for endometrial protection?
- Transdermal (patches)
- Oral (tablets)
- Intrauterine system (Mirena)
Can testosterone be given for menopause?
Yes - can be given as gel of cream. Used for low energy and reduced libido
What is menopause?
The cessation of menstruation
