Menopause and HRT Lecture powerpoint Flashcards
The duality
Menopause definition
Cessation of menses
Climacteric
Time of transition when ovarian function begins to wane, characterized by high FSH but no ovarian response as the individual slowsly stops getting period
Average age of menopause
51, give or take 5-10 years
Cause of menopause
- Estrogen levels decrease with age
- Follicles left in ovary are not responsive to FSH in any conc. (hyporesponsive)
- ovulation stops occuring
A patient who enters menopause under 40 will need…
….hormone replacement therapy due to complications at stopping at such a young age such as osteoporosis
Signs of menopause (3)
- increased hair growth due to androgens no longer converted to estrogens
- erythema from vasomotor flushes
- hot flashes
Low estrogen levels can often result in…
….osteoperosis
HRT’s vs OCP’s
They are very different, they use a different source of estrogen
Premarin
Hormone replacement therapy for women in menopause
Provera
Hormone replacement therapy for women in menopause, continuous estrogen and progesterone
NEVER order what test to determine if a petient is menopausal, because this other test will always do!
Estrogen, FSH is good enough
Best birth control type
Monophasic
Immediately after birth want to use ___ only type birth controls
Progesterone
Premature ovarian failure
Spontaneous cessation of menses <40years old
Hormone replacement therapy benefits
- reduced osteoperosis
- reduced alzheimer’s
- reduced atrophic vaginitis
- improved sexual funcitoning
Bioidentical hormones
Lack of evidence of safety in bioidentical hormones because no studies have been done, therefore they might not be safe, but many patients prefer them because they are natural
Methyltestosterone
Given as part of hormone replacement therapy to replace testsosteorne levels in the female (helps with bone deposition, sex funciton, etc)
Clonidine
HRT for vasomotor symptoms in menopausal women
Methyldopia
HRT given for vasomotor symptoms in meonpusal women
Bellergal
HRT for vasomotor symptoms in menopausal women
Absolute contraindications of HRT
- unexplained vaginal bleeding
- pregnancy
Cyclic HRT vs continuous HRT
Estrogen and progestin, may have withdrawl bleeding on off days to simulate menstrual cycle, continuous is estrogen and progestin without a gap period
Bazedoxifene/conjugated estrogen/duavee
Selective estrogen receptor modulator that when combined with estrogen allows for activity of the bone but antiestrogenic activity on the uterus and breast, making it ideal for cancer prevention
