many-paws Flashcards
changes in menses occur when
-3a (late reproductive stage)
inc in FSH when
-1 late menopausal stage
amenorrhea can last >60 days
-1 late menopause
perimenopause spans
-2 to +1
early menopausal transition to early menopause
decline in fecundity is a hallmark
-3a
late reproductive years
indications for HRT
moderate to severe VMS
prevention of osteoporosis
premature hypoestrogenic state (such as POI or post BSO)
GUSM
baseline labs for menopause
height/weight/BMI
abd circumference
breast exam
pelvic exam
papsmear
TV-UTZ
digital mammogram starting 40
TSH (q5 at 35 then q1 at 60)
FBS, lipid profile
Crea, BUN, UA
LFT
colonoscopy at 50 then q10
STI screen
immunization record
dexa q2 yrs after 65 unless with symptoms
vices
transdermal if
at risk for vte
hyper-TGL
obese with metabolic syndrome
diabetic and hypertensive
smokers
hyposexual/dec libido
vaccines required for elderly
HPV
influenza annual
shingles/zoster
pneumococcal PPSV23 annual
TDAP q10 yrs
low dose estrogen
0.3 - 0.45 CEE
E2V 0.5
Estrogel 0.5mg (1/3 of ruler ~0.5mg)
17B estradiol 0.5-1mg
transdermal 25-37.5 mcg
for GUSM (vaginal)
3 - vagifem, ovestin, estring
1- DHEAS
1 - oral
vagifem tab/estradiol hemihydrate 10mcg/tab 1 tab daily x 2 weeks then 1 tab 2x/week
ovestin cream (estriol) 0.5g cream = 0.5mg estriol
1 applicator for 1st 2-3 weeks max 4 weeks
ESTRING: silicone ring with 2 mg estradiol (7.5 μg/day for 90 days)
Prasterone 0.5% 6.5mg intravaginal gel
Ospemifene 60mg OD
transdermal example
estradiol hemihydrate gel
oestrogel 48mg/80g tube
transdermal estradiol patch
climara 75mcg/patch
moderate dose estrogen
0.625mg CEE
E2V 1mg
Estrogel 1 mg (2/3 of ruler ~1mg)
17B estradiol 1.5-2mg
transdermal E2 50mcg/day
high dose estrogen
1.25 CEE
E2V 2
Estrogel 1.5mg
17B estradiol 2mg
transdermal 75-100 mcg
low dose progesterone
Dydrogesterone 5mg
Micronized progesterone 100mg
MPA 5mg (if cont 2.5mg)
NETA 1.25mg (0.5-1mg if cont)
LNG-IUS 52mgc(20mcg daily)
