Hormone Replacement Therapy Flashcards
On average, how long do these symptoms last for?
4 years
What are the indications for Hormone Replacement Therapy?
- Vasomotor symptoms such as flushing, insomnia and headaches
- Low sexual desire
- Low Mood
- Premature menopause
For hysterectomy before menopause or early menopause, how long should HRT be continued?
To when women would naturally go through the menopause.
~50 years old.
For symptomatic relief, how long should HRT be continued?
~5 years
(Remember that most menopausal symptoms lasted for only 4 years)
For osteoporosis, how long should HRT be continued?
5 years
The minimum period for which benefits have been shown.
Vasomotor symptoms affect how many women going to menopause?
80%
What are the 3 types of oral HRT and who are they used in?
- Oestrogen only - w/o womb. (Hysterectomy)
- Cyclical HRT - Perimenopausal - helps to limit erratic bleeding.
- Continuous combined HRT - use when 1 year later than menopause otherwise erratic bleeding.
How else can HRT be delivered apart from orally?
- Transdemeral patch or topical
- Oral Oestrogen - with Progestogen by Mirena coil
When stopping HRT can it be tapered or stopped abruptly?
Tapering is better over the short term.
Long terms outcomes are the same.
Generally speaking, between what age should HRT be stopped and why?
60-65 years.
Risks start to outweight the benefits.
(If used >60 years - use low doses)
When should patients be reviewed?
3 months THEN
Annually
What should you do as part of your review?
- Discuss S/E.
- Ask about vaginal bleeding.
- BMI
- BP
- Review FH
- Review Medical history
- Calculate 10 year CVD risk.
Oral HRT increases the risk of devleoping what conditions?
- Ovarian cancer
- Breast cancer
- Ischaemic stroke
- VTE
Transdermal HRT DOES NOT increase the risk of what conditions? (that oral HRT does)
- VTE
- Ischaemic stroke
What conditions is HRT contraindicated in?
- Pregnancy.
- Undiagnosed abnormal vaginal bleeding.
- Active or recent blood clot or myocardial infarction (heart attack)
- Suspected or active breast or endometrial (womb) cancer.
- Active liver disease with abnormal liver function tests.
- Porphyria cutanea tarda.