Sex Hormone Responsive Conditions Flashcards
HRT with small doses of oestrogen (together with a progestogen in women with a uterus) is appropriate for relieving which menopausal symptoms?
Vaginal atrophy, vasomotor instability, may diminish postmenopausal oestrogen.
In which women are progestogens added to their HRT?
Women with a uterus.
When is clonidine used as part of HRT?
To reduce vasomotor symptoms in women who cannot take an oestrogen.
Describe the risk of breast cancer associated with HRT.
Increased risk within 1-2 years of starting treatment. Risk is related to duration of use but disappears within five years of stopping.
Describe the risk of endometrial cancer associated with HRT.
Risk depends on the dose and duration of oestrogen only HRT. Risk eliminated if progestogen is given continuously.
Describe the risk of ovarian cancer associated with HRT.
Long-term use is associated with an increased risk, this excess risk disappears within a few years of stopping.
Describe the risk of VTE associated with HRT.
Increased risk of DVT and PE, especially in the first year of use. In women with predisposing factors, it is important to review the need for HRT. Travel involving prolonged immobility further increases DVT risk. Can be reduced with exercise or compression hosiery.
Describe the risk of stroke associated with HRT.
Risk increases with age - older women have a greater absolute risk.
Describe the risk of coronary heart disease associated with HRT.
HRT does not prevent coronary heart disease. Increased risk of coronary heart disease in women who start combined HRT more then 10 years after menopause.
Give some reasons why HRT may need to be stopped immediately.
Sudden severe chest pain. Sudden chest pain. Cough with blood. Unexplained swelling or severe pain in one leg. Severe stomach pain. Serious neurological effects. Hepatitis, jaundice, sudden liver enlargement. Blood pressure above systolic 160mmHg or diastolic 95 mmHg. Prolonged immobility after surgery or leg injury. Detection of contraindicatory risk factor.
What is clomifene?
An anti-oestrogen.
What is clomifene used for?
To stimulate ovulation, used in the treatment of female infertility.
For how long should clomifene be used and why?
For no longer than 6 cycles due to an increased risk of ovarian cancer.
When are androgens (testosterone) used?
In replacement for castrated adults and those who are hypogonadal due to either pituitary or testicular disease.
How do anti-androgens work?
They inhibit the effects of testosterone.
