Hormone Replacement Therapy

All of the following are nonhormonal therapy of menopause except

A. Ibandronate

B. Calcitonin

C. Tibolone

D. Raloxifene

All are true regarding treatment of menopausal symptoms except

A. Raloxifene is given to reduce hot flushes
B. HRT stimulates new bone formation.
C. Soy protein can act as SERMS.
D. Isoflavones can reduce risk of breast cancer

HRT can be prescribed in the following conditions  except

 A. Premature ovarian failure

 B. Gonadal dysgenesis

 C. Surgical or radiation menopause

 D. Alzheimer’s disease

Which of the following is effective for hot flushes in menopause

A. Raloxifene
B. Clonidine
C. Calcitonin
D. Bisphosphonates

Following are benefits of HRT except

 A. Reduction in colorectal cancer

 B. Helpful in dementia

 C. Cardioprotection

 D. Improvement urogenital atrophy

Ideal serum level of estradiol should be _ during HRT therapy

 A. 100 pg/ml

 B. 50 pg/ml

 C. 200 pg/ml

 D. Not above 70pg/ml

All are true regarding  HRT therapy except

 A. Hormone therapy of choice for women in early menopausal transition is LNG-IUS

 B. Women with intact uterus should get EPT

 C. With transdermal estrogen spray stable level can be achieved in 48hrs

 D. Hormonal contraception without a hormone-free interval is suitable for premature ovarian failure

Which is a risk of  HRT therapy?

 A. Dry eye syndrome

 B. Glaucoma

 C. Migraine

 D. Cataract

In short

  • Tibolone is a therapy of choice for women with a history of endometriosis
  • Estetrol or 15α-hydroxyestriol can be used as hormone replacement in women after breast cancer surgery
  • Bazedoxifene (BZA) is a new SERM without risks of stimulating breast tissue or endometrium
  • The important sources of phytoestrogens are  soya, varieties of cohosh, red grapevine, cereals, rice, strawberries, garlic, liquorice, and dates.

What are the indications of HRT for menopausal issues include:
  1. Treatment of vasomotor symptoms of menopause
  2. Treatment of genitourinary syndrome of menopause ( previously known as vaginal and vulvar atrophy)
  3. Prevention of osteoporosis

What is progestogen ?

Progestogen is a term used to include not only progesterone made by the human ovary but also progesterone-like substances, also known as progestins.

What are the FDA-approved indications for progestogens ?

Indications for progestogens include

  1. Amenorrhea, either primary or secondary
  2. Assisted reproductive technology treatment
  3. Endometrial hyperplasia
  4. Dysfunctional uterine bleeding

What is the effects of estrogen on blood clot and atherosclerotic plaque?
  1. Estrogen administered orally – results in increased activated protein-C resistance, increasing the risk of a blood clot.
  2. Oral estradiol induces the hepatic formation of matrix metalloprotease 9, which decreases the formation and rupture of atherosclerotic plaque.
  3. Transdermal Estrogen: Bypasses the hepatic metabolism that produces activated protein-C resistance, and the risk for blood clotting is negated.

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