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23 Cards in this Set

  • Front
  • Back
What are changes that occur during menopause?
• decreased estrogen secretion
• decreased progesterone
• increased gonadotropins
• loss of ovarian function
How is menopause diagnosed?
• history and physical (hot flashes is the 1st sign)
• amennorrhea for one or more years
• FSH level greater than 30-40
What are symptoms of estrogen deficiency?
• vasomotor instability (hot flashes)
• genitourinary atrophy
• osteoporosis
• cardiovascular disease
What are causes of vasomotor instability (hot flashes)?
dysregulaion of hypothalamic thermoregulation
What is the treatment of vasomotor instability (hot flashes?
• limit caffeine and alcohol
• estrogens
• clonidine
What are symptoms of geitourinary atrophy caused by estrogen deficiency?
• Vagina:
- decreased secretions
- dryness
- increase in vaginal pH
- itching

• Urinary tract:
- frequency
- incontinence
- urgency
What is the treatment for genitourinary atrophy?
• oral or vaginal estrogens
• lubricants
What is the effect of estrogen on the cardiovascular system?
• CAD increases after menopause
• estrogen decreases LDL & platelet adhesion, and increases HDL
List examples of estrogen replacement therapy
• conjugated estrogen (Premarin)
• esterified estrogen (Estratab)
• Estropriate (Ogen or Orthoest)
• Ethinyl estradiol (Estinyl)
• Micronized estradiol (Estrace)
What is the dose for conjugated estrogen (Premarin)?
0.3-0.625 mg QD
What is the dosage for Ethinyl estradiol (Estinyl)?
0.02-0.05 mg QD
Give examples of estrogen replacement therapy that is available as a transdermal patch
• weekly patch:
- Climara
- Fempatch

• 2 times a week patch:
- Estraderm
- Alora
Which estrogen replacement therapies are available as vaginal creams?
• conjugated estrogen (Premarin)
• Estropriate (Ogen)
• micronized estradiol (Estrace)
What are risks/adverse effects of estrogen replacement therapy?
• breast cancer
• endometrial hyperplasia
• gallbladder disease (2-4 times risk of gallstones)
• migraine headaches
Estrogen should be used with progesterone for women with an intact uterus. What are the effects of progesterone when used in combination as hormone replacement therapy?
• reduces estrogen-induced irregular bleeding
• reduces endometrial hyperplasia
• enhances estrogen activity
What is the most common progestin therapy?
Medroxyprogesterone Acetate
What is the effect of Medroxyprogesterone Acetate on lipid profile?
has a negative effect on lipid profile (increases LDL)
What are side effects of Medroxyprogesterone Acetate?
• bloating
• irritability
• depression
What drugs are incorporated into the Combipatch?
• Estradiol/Norethindrone Acetate
• applied 2x/wk
• may be used continuously
What are the different types of HRT regimens?
• Cyclic:
- 5 days of Medroxyprogesterone Acetate
- Estrogen 28 days, Progesterone 14 days

• Continuous:
- estrogen and progesterone everyday
What are adverse effects of continuous HRT?
• irregular bleeding
• can lead to atrophy of endometrium
• amennorhea
Prempro is a combination of what drugs?
• Conjugated estrogen (Premarin)
• Medroxyprogesterone Acetate (Provera)
What should be monitored for a patient on HRT?
• FSH levels
• breast and pelvic exams
• lipid, glucose, & thyroid tests
• assess need for treatment yearly