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HRT Quiz. Dr Sylvia Bond 16/9/09. Below what age is menopause premature?. How long is contraception advised after LMP?. Is PMH cancer of cervix a contraindication to HRT?. Name 3 absolute contraindications. Name 2 conditions HRT reduces the long term risk of.

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hrt quiz

HRT Quiz

Dr Sylvia Bond

16/9/09

slide10
What is the equivalent dose of HRT from Premarin 0.625mg tablets a. Oestrodiol tabletsB. Oestrodiol patches
name a type of hrt for the followingwomen with menopausal symptoms
Name a type of HRT for the followingwomen with menopausal symptoms
  • 1 point type and 1 point brand name
  • Cyclical( sequential)
  • CCT ( Continuous Combined Therapy)
  • Unopposed Oestrogen
  • Topical Oestrogen
  • Mirena ( IUS) + unopposed oestrogen
below what age is menopause premature21
Below what age is menopause premature?
  • 45years
  • Normal range of menopause 45-55 years
  • Menopause is last menstrual period
  • Peri-menopause may last 10 years+ with symptoms
how long is contraception advised after lmp23
How long is contraception advised after LMP?
  • 1 year if over 50 years
  • 2 years if under 50 years
is pmh cancer of cervix a contraindication to hrt25
Is PMH cancer of cervix a contraindication to HRT?
  • No
  • PMH cancer of ovary is also not contraindicated as not Oestrogen sensitive.
name 3 absolute contraindications27
Name 3 absolute contraindications

Pregnancy

Undiagnosed abnormal bleeding

Breast or endometrial cancer

Severe liver disease

PMH Thrombosis

Migraine with aura

name 2 conditions hrt reduces the long term risk of29
Name 2 conditions HRT reduces the long term risk of
  • Osteoporosis
  • Bowel cancer
  • ? Alzheimer’s disease
name 1 non hormonal alternative to treat hot flushes31
Name 1 non-hormonal alternative to treat hot flushes
  • Dixarit ( Clonidine)
  • Black Cohosh
  • Red Clover
  • Kava Kava
  • Angus castus
  • Magnesium/Zinc
  • Phytoestrogens ( Soya /Yam)
  • Evening Primrose oil
  • SSRIs
what fsh level would indicate menopause33
What FSH level would indicate menopause?
  • 32 iu

May need to repeat to confirm if basing advice on contraception on result, e.g. When amenorrhoea with IUS and deciding when safe to remove.

when is cct hrt indicated continuous combined therapy35
When is CCT HRT indicated? ( Continuous combined therapy)
  • 12 months after LMP or over 54 years

If using cyclical ( sequential) HRT offer swap at 54 years on review or repeat prescription and monthly withdrawal bleeds should stop.

what is the equivalent dose of hrt from premarin 0 625mg tablets
What is the equivalent dose of HRT from Premarin 0.625mg tablets

A. Oestrodiol tablets = 1 mg

B. Oestrodiol patches = 50mcg

name a type of hrt for the followingwomen with menopausal symptoms37
Name a type of HRT for the followingwomen with menopausal symptoms
  • 1 point type and 1 point brand name
  • Cyclical( sequential)
  • CCT ( Continuous Combined Therapy)
  • Unopposed Oestrogen
  • Topical Oestrogen
  • Mirena ( IUS) + unopposed oestrogen
51yrs lmp 6 12 ago iddm39
51yrs , LMP 6/12 ago, IDDM
  • Cyclical HRT Still perimenopausal
  • Premique cycle MPA good for lipids and CVD risk
49yrs menorrhagia and needs contraception41
49yrs, menorrhagia and needs contraception
  • IUS + Unopposed Oestrogen
  • Mirena + Premarin 0.625mg/ Oestrodiol 1mg
  • May consider HRT + barrier methods
58yrs c o loss of libido43
58yrs, c/o loss of libido
  • Tibolone ( Livial )
  • CCT
weight gain on premique cycle 52yrs45
Weight gain on premique cycle, 52yrs
  • Alternative Cyclical HRT
  • Femoston 1/10mg
52yrs pmh of tah flushes despite premarin o 625mg47
52yrs, pmh of TAH,flushes despite premarin o.625mg
  • Unopposed Oestrogen
  • Double dose to 1.25mg
  • Or try Oestrodiol 2mg or patch/gel
  • Or add non hormonal remedy
55yrs stopped hrt 1 year still has flushes no bleed since hrt49
55yrs, stopped HRT 1 year still has flushes. No bleed since HRT
  • CCT, lowest dose possible
  • Kliovance ( 1 mg Oestrodiol+ P)
  • Premqiue low dose ( 0.325mg premarin+ P)
77yrs recurrent uti and urethritis51
77yrs recurrent uti and urethritis
  • Topical Oestrogen
  • Premarin
  • Oestrogel