HRT Flashcards

1
Q

What non hormonal treatments can be used initially for menopausal symptoms ?

A
  • Lifestyle changes : improving the diet, exercise, weight loss, smoking cessation, reducing alcohol, reducing caffeine and reducing stress
  • CBT
  • Clonidine
  • SSRI antidepressants (e.g. fluoxetine)
  • Venlafaxine (SNRI)
  • Gabapentin
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2
Q

What is clonidine and why is it used to help menopausal symptoms ?

A
  • Alpha-2-adrenergic and imidazoline receptor agonist
  • Helps vasomotor Sx and hot flushes
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3
Q

Give 4 SE of clonidine

A

Dry mouth
Headache
Dizziness
Fatigue

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4
Q

Give 8 contraindications to HRT

A
  • Undiagnosed abnormal bleeding
  • Endometrial hyperplasia or cancer
  • Breast cancer
  • Uncontrolled hypertension
  • Venous thromboembolism
  • Liver disease
  • Active angina or myocardial infarction
  • Pregnancy
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5
Q

What are the 3 steps to commencing HRT?

A
    1. Local or systemic Sx ? -> systemic go to step 2
    1. Uterus ? -> no uterus give continuous oestrogen only HRT. Has uterus = combined HRT and go to step 3.
    1. Period in last 12 months ? -> perimenopausal give cyclical combined HRT. Postmenopausal continuous combined.
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6
Q

What is the best way of delivering oestrogen in HRT ?

A
  • Patches : reduced rusk of VTE
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7
Q

What is the best way of providing progesterone in HRT?

A
  • Mirena coil
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8
Q

What are the oestrogenic SE of HRT

A

Nausea and bloating
Breast swelling
Breast tenderness
Headaches
Leg cramps

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9
Q

What are the progestogenic SE of HRT

A

Mood swings
Bloating
Fluid retention
Weight gain
Acne and greasy skin

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10
Q

when can you switch from cyclical to continuous HRT ?

A
  • After at least 12 mnths of treatment in women over 50, and 24 mnths in women under 50 .
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11
Q

HRT if perimenopausal but suffers from migraines with aura

A

Topical cyclical combined oestrogen

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12
Q

Counselling regarding oral progesterone (norethisterone) for example kin addition to the oestrogen patch

A

Increased risk of breast cancer (also VTE and CVD risk)

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13
Q
A
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