Parker Study Guide Pg 1

Question 1

1. What hormones have increased release during menopause?

Answer 1

FSH and Estrone (E1)

Question 2

1. What hormones have decreased release during menopause?

Answer 2

Inhibin and E2 (Estradiol)

Question 3

Which of the three estrogens is not necessary for most adults, but pharmacies love it due to the money that can be made from it?

Answer 3

E3 - Estriol

Question 4

1. What are three short term complications of menopause?

Answer 4

1. Hot flushes (vasomotor instability - E withdrawal - narrowing of thermoreg. zone -> increase sensitivity to temp changes)
2. Mood changes
3. Atrophy of urogenital tissues (estrogen or other meds)

Question 5

1. What are three long term consequences of menopause?

Answer 5

1. Increased cardiovascular disease
2. Fat redistritubion
3. Osteoporosis

Question 6

1. What are three treatments for the long term consequence of osteoporosis?

Answer 6

Bisphosphates and Calcium, vitamin D, and Estrogen

Question 7

1. What are the dental concerns for women with osteoporosis?

- What are the concerns for them regarding the use of bisphosphates?

Answer 7

• Loosening of teeth
• Jaw osteonecrosis (from bisphosphates)
• Burning mouth syndrome
• Gingivostomatitis or atrophic gingivitis resulting from drying of the oral tissues

Question 8

1. What kind of treatment may be recommended for postmenopausal women with gingival bleeding and risk of tooth loss?

Answer 8

Estrogen replacement therapy - associated with less gingival bleeding and may be beneficial in preventing tooth loss

Question 9

2. What are the 2014 hormone replacement therapy recommendations?

Answer 9

1. Use lowest dose for the shortest time
2. Have other medication options for host flushes and other symptoms
3. Keep ongoing surveillance for osteoporosis and oral health

Question 10

3. List the three types of estrogen in decreasing potency

Answer 10

Estradiol (E2) > Estrone (E1)> Estriol (E3)

Question 11

3. Which of the three types of estrogen is the primary hormone before menopause?

Answer 11

Estradiol (E2)

Question 12

3. Which of the three types of estrogen is the primary hormone after menopause?
   - Where is it found?

Answer 12

Estrone (E1)

Found in fat cells

Question 13

3. Which of the three types of estrogen is made by the placenta and is not necessary in adults?

Answer 13

Estriol (E3)

Question 14

4. What are two benefits of hormone replacement therapy?

Answer 14

Decreases bone fractures and risk of colon cancer

Question 15

4. What are two negatives of hormone replacement therapy?

Answer 15

Increased breast / endometrial cancer
Blood clots (Deep Vein Thrombosis)

Question 16

5. What are the three forms of combined contraceptive options?

Answer 16

1. Contraceptive pills
2. Vaginal ring
3. Transdermal

(Estrogen + Progesterone)

Question 17

5. What are two contraindications for usage of combined contraception?

Answer 17

1. Cancer

2. Blood clots (deep vein thrombosis)

Question 18

5. What is the medical eligibility criteria for contraceptive use for each of the combined contraceptive options?

Answer 18

1. Contraceptive pills - daily for three weeks, placebo for one week
2. Ring - three weeks ring in, one week out
3. Patch - Apply one patch a week for three weeks, then one week no patches

Question 19

5. What are the two mechanisms of action for estrogen’s contraception use?

Answer 19

1. Builds endometrial lining

2. Suppresses FSH to interfere with the development of the dominant follicle

Question 20

5. What is the mechanism of action for progesterone only contraception?

Answer 20

1. Thickens cervical mucus
2. Impairs mobility in fallopian tube
3. Delays or prevents LH surge and ovulation (via suppression of GnRH)

Question 21

5. What are three forms of progestin only contraception?

Answer 21

1. Pills
2. Depo Provera
3. Implant

Question 22

5. Progestin-Only Contraceptive pills
   - Ovulation suppression rate vs COC’s?
   - Break weak?
   - This option is great for nursing and women with a contraindication towards what hormone?

Answer 22

1. 57% ovulation suppression for POCs vs 95% for COCs
2. No break weak due to very low serum conc.
3. Good for nursing and women with estrogen contraindications

Question 23

5. Depo Provera injection
   - How often is it administered?
   - What are three risks?

Answer 23

1. Administered every three months

2. Increased weight, irregular bleeding, and possible risk for loss of bone density

Question 24

5. Implant - Intradermal progestin-only contraception

- Effective for how long?

Answer 24

3 years

Question 25

5. Implant - Intrauterine Progestin-only contraception - Mirena - Effective for how long? - Useful not only for contraception, but also reduces heavy _____ - Not to be used for what purpose? - Advised not to insert IUD if what is present?

Answer 25

- Effective for five years - Useful in reducing heavy bleeding - Not to be used as an emergency contraceptive - Advised not to insert if STI's present