Hormone Replacement Therapy Flashcards
When and why is HRT done
- during menopause to reduce its symptoms
- patient must have a uterus
What are menopausal symptoms
Vaginal Atrophy:
thinner, dryer, inflamed vaginal walls
Vasomotor Instability :
temperature change, swelling
What is an alternative treatment fir menopausal symptoms other than HRT
Clonidine
(but is has a large side effects profile)
Which HRTs increase the risk of: Breast Cancer
- Combined HRT
(increase risk in taken more than 1 year)
Which HRTs increase the risk of: Endometrial Cancer
increase risk with Tibolone (artificial HRT)
Which HRTs increase the risk of: VTE
increases risk if sedentary, obese or family history
Which HRTs increase the risk of: Ovarian Cancer
small increase with HRT, but disappears after a few years
Which HRTs increase the risk of: Stroke
all HRT increases risk
Which HRTs increase the risk of: Coronary Heart Disease
increased risk in combined
What are the 2 HRT regimens if a patient has a uterus
- Oestrogen everyday
(last 12 to14 days of the cycle, use progesterone) - Combined continuous use of both
(avoid in perimenopause- period when body start to move into menopause))
What is the HRT regimen if a patient has a uterus
Oestrogen only
(add progesterone if endometriosis occurs)
What should you do if you are taking HRT and you have elective surgery
- stop HRTT 4 to 6 weeks before
- restart when fully mobile
What should you do if you are taking HRT and you have non-elective surgery
- use prophylactic heparin
- use a graduated compression stocking
What are reasons to stop HRT
- sudden severe chest pain/breathlessness
- swelling/pain in calf (DVT)
- severe stomach pain, jaundice (hepatotoxicity)
- severe neurological effects
- High BP
- prolonged immobility
