HRT Flashcards
What are the oestrogens HRT good for
Oestrogens are necessary for the development of female secondary sexual characteristics
Alleviate the symptoms of menopause
What are the symptoms of menopause
Hot flushes
Vaginal atrophy
Skin aging
Vaginal dryness
Decreased muscle mass
Sexual dysfunction
Bone loss
What is early and late menopause
< 45 years = early
Above or equal to 50 years = normal
What are some natural oestrogens
estradiol (oestradiol), estrone (oestrone), and estriol (better than synthetic)
What are some synthetic oestrogens
ethinylestradiol and mestranol
What activity does tibolone have
Ostrogenic, progestogenic and weak androgenic activity
Therefore progesterone doesn’t have to be given alongside
What can be given to reduce vasomotor symptoms in women who cannot take oestrogen?
Clonidine hydrochloride
What is the disadvantage of clonidine hydrochloride
Unwanted SE
What can HRT increase the risk of
HRT increases the risk of venous thromboembolism, stroke, endometrial cancer (reduced by a progestogen), breast cancer, and ovarian cancer
There is an increased risk of coronary heart disease in women who start combined HRT more than 10 years after menopause.
How long should HRT be stopped before surgery
4 to 6 weeks
What if HRT discontinuation is not possible before surgery
Prophylaxis with unfractionated or low molecular weight heparin and graduated compression hosiery is advised.
What are some reasons to stop HRT
Sudden severe chest pain (even if not radiating to left arm);
Sudden breathlessness (or cough with blood-stained sputum);
Unexplained swelling or severe pain in calf of one leg;
Severe stomach pain;
Serious neurological effects including unusual severe, prolonged headache especially if first time or getting progressively worse
Sudden partial or complete loss of vision or
Sudden disturbance of hearing
Hepatitis, jaundice, liver enlargement;
Blood pressure above systolic 160 mmHg or diastolic 95 mmHg;
Prolonged immobility after surgery or leg injury
What is Ethinylestradiol used for
Licensed for short-term treatment of symptoms of oestrogen deficiency
For osteoporosis prophylaxis if other drugs cannot be used
Treatment of female hypogonadism and menstrual disorders.
What is raloxifene used for
Treatment and prevention of postmenopausal osteoporosis;
What are the 2 main groups of progestogens?
Progesterone and its analogues (dydrogesterone and medroxyprogesterone acetate)
Testosterone analogues (norethisterone and norgestrel)
