NURS 5432 Exam Study Guide (Menopausal Hormone
Therapy)
Purpose: Manage vasomotor symptoms, prevent osteoporosis
Estrogen Therapy
• Types:
o 17β-Estradiol (e.g., Estrace) o Conjugated estrogens (e.g.,
Premarin) o Synthetic conjugated estrogens Routes:
o Oral
o Transdermal patch (e.g., Climara, Vivelle-Dot) o Gel (e.g.,
EstroGel) o Topical emulsion
o Transdermal spray (e.g., Evamist)
• Contraindications: Undiagnosed vaginal bleeding, estrogen-dependent malignancies,
history of DVT, migraines with aura, active endometriosis, liver disease, strong family
history of breast cancer
• Adverse Effects: Nausea, breast tenderness, ↑ BP, ↑ triglycerides, peripheral edema,
↑ VTE risk, anemia (early use), ↑ risk of breast and endometrial cancer
• BBW: Dementia risk >65 yrs
Progestin Therapy
• Purpose: Protect against endometrial hyperplasia when using estrogen
• Types:
o Medroxyprogesterone acetate (Provera) o Norethindrone
acetate o Drospirenone
o Levonorgestrel
• Adverse Effects: Headache, depression, weight gain, ↓ libido, acne, hirsutism
(androgenic types), hyperkalemia (Drospirenone)
Combined HRT Options
• Oral Cyclic: Premphase
• Oral Continuous: Prempro, Premplus
• Oral Intermittent: Prefest
• Transdermal: CombiPatch, Climara Pro
Selective Estrogen Receptor Modulators (SERMs)
• Tamoxifen: Breast cancer treatment/prevention; risk of endometrial cancer, hot flashes
• Raloxifene (Evista): Osteoporosis, breast cancer prevention; no ↑ endometrial cancer
risk, ↓ cholesterol
• Clomiphene (Clomid): Induces ovulation via ↑ GnRH
Therapy)
Purpose: Manage vasomotor symptoms, prevent osteoporosis
Estrogen Therapy
• Types:
o 17β-Estradiol (e.g., Estrace) o Conjugated estrogens (e.g.,
Premarin) o Synthetic conjugated estrogens Routes:
o Oral
o Transdermal patch (e.g., Climara, Vivelle-Dot) o Gel (e.g.,
EstroGel) o Topical emulsion
o Transdermal spray (e.g., Evamist)
• Contraindications: Undiagnosed vaginal bleeding, estrogen-dependent malignancies,
history of DVT, migraines with aura, active endometriosis, liver disease, strong family
history of breast cancer
• Adverse Effects: Nausea, breast tenderness, ↑ BP, ↑ triglycerides, peripheral edema,
↑ VTE risk, anemia (early use), ↑ risk of breast and endometrial cancer
• BBW: Dementia risk >65 yrs
Progestin Therapy
• Purpose: Protect against endometrial hyperplasia when using estrogen
• Types:
o Medroxyprogesterone acetate (Provera) o Norethindrone
acetate o Drospirenone
o Levonorgestrel
• Adverse Effects: Headache, depression, weight gain, ↓ libido, acne, hirsutism
(androgenic types), hyperkalemia (Drospirenone)
Combined HRT Options
• Oral Cyclic: Premphase
• Oral Continuous: Prempro, Premplus
• Oral Intermittent: Prefest
• Transdermal: CombiPatch, Climara Pro
Selective Estrogen Receptor Modulators (SERMs)
• Tamoxifen: Breast cancer treatment/prevention; risk of endometrial cancer, hot flashes
• Raloxifene (Evista): Osteoporosis, breast cancer prevention; no ↑ endometrial cancer
risk, ↓ cholesterol
• Clomiphene (Clomid): Induces ovulation via ↑ GnRH
