Hormone Replacement Therapy Flashcards
List the types of menopausal symptoms
- Vasomotor (Hot flushes on the face, neck, chest, night sweats)
- Vaginal dryness
- Low mood
List the oral estrogen preparations
- Estrofem (Estradiol 1mg tab)
- Progynova (Estradiol 2mg tab)
- Premarin (Conjugated estrogen 0.625 mg tab)
List the non-oral estrogen preparations
- Oestrogel (Estradiol 0.06% gel)
- Vagifem (Estradiol 25 mcg vaginal tablet)
- Premarin (Conjugated estrogen 0.625 mg vaginal cream)
What are the indications for estrogen therapy (and specific to the formulation)?
Goals:
1. Treat menopausal symptoms
2. Prevent osteoporosis
Oral: Relieve vasomotor symptoms
Transdermal (Oestrogel): Relieve menopausal symptoms in general
Intravaginal (Premarin, Vagifem): Vulvar and vaginal atrophy related to menopause
Role of Progestogens in hormone replacement therapy
Add on to long term estrogen therapy in women with intact uterus to prevent cystic hyperplasia of endometrium and possible transformation to cancer
What are the 2 main groups of progestogens
- Progesterone + Progesterone analogue (Dydrogesterone, Medroxyprogesterone)
- Testosterone + Testosterone analogue (Norethisterone, Norgestrel)
List of Progestogen therapy
- Duphaston (Dydrogesterone 10 mg tablet)
- Provera (Medroxyprogesterone acetate 5 mg tablet)
- Utrogestan (Micronized Progesterone 100 mg capsule)
List of combination preparations
- Femoston 1/10, 2/10, Conti 1/5 (Estradiol / Dydrogesterone)
- Activelle (Estradiol 1 mg, Norethisterone 0.5 mg)
- Trisequens
- Estradiol 2mg (12 Blue tablets)
- Estradiol 2mg / Norethisterone 1mg (10 White tablets)
- Estradiol 1mg (6 Red tablets) - Progyluton
- Estradiol valerate 2mg (11 white tablets)
- Estradiol valerate 2 mg / Norgestrel 500 mcg (10 light brown tablets)
What is the activity of Livial (Tibolone 2.5 mg)?
Estrogenic + Progestogenic + Weak androgenic activity
How should you take Estrogen-only HRT? (Also list examples of products)
For separate progestogen, how do you take it?
Premarin® / Estrofem® / Progynova®
Take 1 tab daily without break at the same time every day
Progestogen: Take 1 tab daily for 10 to 14 days each month. You will experience a withdrawal bleed (menses) after finishing the progestogen tablets.
How should you take continuous combined therapies? (Also list the products)
Activelle®, Femoston® Conti 1/5
Take 1 tab daily without break at the same time every day
Why must you take hormone pills at the same time every day?
To avoid huge fluctuations in hormone levels that can affect mood and symptoms
How should you take continuous estrogen and cyclic progestogen therapies? (Also list the products available)
Femoston® 1/10 (white/grey) and Femoston® 2/10 (red/yellow)
There are 14 estrogen-only and 14 estrogen / progestogen tablets in one pack.
Take one tablet without break at the same time daily
At the end of each pack, you will experience withdrawal bleed (menses) once a month
How should you take triphasic therapies? (Also list the products available)
Trisequens®
Take one tablet daily without break, preferably at the same time every day.
When a pack is finished, the next pack should be started without any break.
You will experience a withdrawal bleed (menses) once a month.
How should you take cyclic estrogen and progestogen therapies? (Also list the products available)
Progyluton
Take 1 tablet daily for 21 days in a row at the same time every day.
After completion of the pack, there will be 7 days where you do not need to take any tablets (7-day tablet-free interval), during which you will experience withdrawal bleeding (menses).
Start taking your next pack of medication after the 7-day tablet-free days, even if you are still having menses.
