Menopause

Question 1

What are indications for menopausal hormone therapy?

Answer 1

relief symptoms, prevent osteoporosis, maintain QOL, POI, surgical or radiation menopause

Question 2

What are the 3 medications approved for vasomotor symptoms in menopause

Answer 2

hormone therapy, paroxetine, desvenlafaxine

Question 3

What are contradinications to hormone therapy

Answer 3

bleeding, breast cancer, estrogen neoplasia, DVT, PE, CVD, pregnancy, liver problem
can give it to people who smoke

Question 4

What is the timing hypothesis in regards to hormone therapy for menopause

Answer 4

need to give closer to menopause onset for favorable lipid and endothelial effects. if given later there are prothrombotic effects

Question 5

Who should you give ET vs EPT for wrt to menopause

Answer 5

ET: undergone hysterectomy or vaginal symptoms
EPT: women with a uterus, progesterone reduces risk of endometrial adenocarcinoma

Question 6

4 types of ET for HT for menopause

Answer 6

Estradiol
micronized estradiol
conjugated estrogen- mix of estrogen (from pregnant mares)
esterified estrogen (different mix of estrogens)
All doses are 6x less than what’s in OCPs

Question 7

What is the advanced of continuous combined instead of continuous cyclic

Answer 7

cyclic will have progesterone withdrawal bleeding, most people want less so continuous combined is good

Question 8

Oral form ET is most common and could increased ____ and ____, pumps up the ____ and decreases ____

Answer 8

HDL and triglycerides
Liver (hepatic globulins, coagulation, etc)
E-selectin

Question 9

Transdermal, topical, vaginal ET administration might have a reduced effect on _____, and _____

Answer 9

sexual function, VTE

Question 10

Micronized progesterone can’t be used in women with ____ and has a ____ effecting

Answer 10

peanut allergy, sedating effects

Question 11

Progestin card

Question 12

Bioidentical hormone therapy is really

Answer 12

a marketing gimmick. its not any safer than the progestin or micronized progesterone

Question 13

Treatments for genitourinary symptoms of menopause

Answer 13

moisturizers + lub, vaginal and pelvic floor activity.

Pharm: vaginal ET, vaginal DHEA, ospemifine, systemic ET (when also VMS)

Question 14

5 decision points with HT

Answer 14

menopause? uterus? indication for HT? within 10 years of menopause/under 65y.o? oral, TD, topical?

Question 15

Fexolinetant is not on the market yet but works _______

Answer 15

KNDY neuron 3 receptor antagonist (non-hormonal)

reduced symptoms by more than 50% in most pt, and improved QOL

Question 16

____ becomes the predominant estrogen postmenopausal because no more no more _____ from follicles.

Answer 16

Estrone, estradiol. Estrone will be made from peripheral conversion of androstenedione

Question 17

Menopause is a clinical ____ diagnosis

Answer 17

retrospective

Question 17

Menopause is a clinical ____ diagnosis

Answer 17

retrospective