Sex Hormones

Question 1

Oestrogen therpat is given clinically or continuously for a number of gynaecological conditions. If long-term therapy is required in women with a uterus what should happen and why

Answer 1

A progesterone should be added to reduce risk of cystic hyperplasia of endometrium or foci if no uterus and possible transformation to cancer

Question 2

Are oestrogens used to suppress lactation

Answer 2

No longer used because of their association with thromboembolism

Question 3

Tx of menopausal atrophic vaginitis

Answer 3

Short course of topical vaginal oestrogen preparation used for a few weeks and repeated if necessary

Question 4

Tibilone dose and when

Answer 4

2.5mg
Used in oestrogen deficiency
OP prophylaxis in women at high risk of fractures when others are CI

Question 5

HRT can be used in women with early natural or surgical menopause - before age of 45- as high risk of OP. For early menopause HRT is given till when

Answer 5

Approximate age of natural menopause which is normally 50

Question 6

What can you use instead of oestrogen to reduce vasomotor symptoms in women

Answer 6

Clonidine hydrochloride

Eg might be able tot ake due to liver damage

Question 7

What does HRT increase risk of

Answer 7

VTE
STROKE
Endometrial cancer - reduced by progesterone
Breast cancer
Ovarian cancer
Corenary heart disease if started combined HRT more than 10years after menopaus e
Decline in cognitive function

Question 8

Does HRT increase risk of of breast cancer

Answer 8

After 1 year of use
Higher for combined and continuous wherre o and p are taken throughout each month
Duration of use not age at which started

Question 9

Are vaginal preparation of HRT containing low doses of oestrogen to treat local shmtpoms linked to breast cancer

Answer 9

No

Question 10

How do you reduce risk of endometrial cancer when on HRT

Answer 10

Add progesterone continuously

Question 11

Small risk associated with ovarian cancer does this dissapear after stopping

Answer 11

Excess risk reduces after stopping HRT

Question 12

Women using what Hrt are at increased risk of VTE and when is this risk most prominent

Answer 12

Combined or oestrogen onlt HRT
UN THE FIRST YEAR

Question 13

What form of HRT is best for VTE risk

Answer 13

Transdermal route

Question 14

What routes avoid first pass metabolism

Answer 14

Transdermal and oral

Question 15

Ethinylestradiol used when

Answer 15

Oestrogen deficiency
OP prophylaxis
Female hypogonadism
Menstrual disorders
Palliative treatment of prostate cancer