HRT counselling Flashcards
intro into menopause
as you get older ovaries make less oestrogen
average age 51 (earlier in hysterectomy)
if ovaries removed –> menopausal symptoms straight away
symptoms (if any)
short term:
hot flushes (3 in 4) start just before & last 3-4 yrs
night sweats
headaches, tired, palpitations, irritable, difficulty sleeping, depression, anxiety, aches & pains, loss of libido
long term:
skin dry, thin, itchy,
vaginal/vulval atrophy
ris osteoporosis (esp if other RFs present)
what is HRT
oestrogen replacement
tablets, skin patches, gels, nasal spray, implants
HRT regime if still having periods
cyclical
daily oestrogen
progesterone for 12-14 days of cycle
regular bleed every 28 days (light period)
later switch to continuous combined HRT
> -1 year since no periods
continuous combined HRT - oestrogen & progesterone everyday
no monthly bleed
spotting/mild irregular bleeds
When do we give Oestrogen + Progesterone?
With uterus + periods
When do we give oestrogen only?
No uterus
What are other non hormonal ways of dealing with menopause
CBT + SSRI
Lifestyle changes (smoking, caffeine, stress)
Tests before taking HRT?
BMI / BP
Tests during HRT?
3 months in BMI / BP
(E) effects take how long?
3-6months
benefits of HRT
menopause symptoms ease
long-term (years) HRT protect against osteoporosis & bowel cancer
risks of HRT
DVT
stroke
breast cancer (slight increase in risk)
uterine cancer (progesterone protective)
HRT side effects
nausea
weight gain
breast discmofort
leg crampls
headaches/migraines
dry eyes
lifestyle
use contraception
