Menopause And HRT Flashcards
Define perimenopause, pre-menopause abd menopause
Perimenopause - the time from which menses become irregular until the last normal menstrual period (first clinical features appear)
Pre-menopause - 1-2 years before menopause. Cessation of menstrual bleeding for a continous 12-month period.
Menopause - cessation of menstrual bleeding for a continous 12-month period.
What are some risk factors for menopause?
Genetics, smoking, family history, alcohol consumption
What are some tale-tell signs of menopause?
Menstrual irregularity, vasomotor symptoms (hot flushes), breast tenderness and swelling.
What are the regimens available for menopause?
Estrogen and Progesterone therapy is available. Women with an intact uterus, progesterone + estrogen is used to protect the lining of the uterus from overstimulation by estrogen.
Progestrone is added to reduce the risk of endometrial hyperplasia.
What is the duration of these treatments?
For VMS, 5 years then stop to evaluate whether symptoms have stopped. Prevention and Rx of osteoporosis - lifelong because bone mineral density falls after stopping Rx.
What are some adverse effects of HRT?
Estrogen-related: fluid retention, breast tenderness, nausea, bloating, headaches.
Progesterone-related: depression, mood swings, acne, lower abdominal pain
What are some genitourinary symptoms?
Vulvovaginal atrophy, vaginal dryness, pain during coitus (dyspareunia), recurrent urinary tract infections.
What are some treatments for genitourinary symptoms?
Locally administered estrogen/ systemic estrogen.
What is the MOA and indication of raloxifene?
Its a selective estrogen receptor modulator. It has anti-estrogen effects on breast and uterus. It has estrogenic effects on bone, lipid metabolism and blood coagulation. Its indicated to prevent and treat postmenopausal osteoporosis.
What are some pharmacokinetic properties and adverse effects?
Rapid absorption and highly protein bound. Adverse effects: peripheral edema, leg cramps, insomnia and weight gain.
