LATEST Perimenopause & Menopause

Angelique - correct answerstablets-take daily Estradiol 0.5mg or 1mg Drosperinone 0.25mg or 0.5mg Breast Cancer and estrogen therapy: - correct answers- estrogen+progesterone incr risk invasive breast cancer - risk incr with 5 or more years of use (hard to pick up breast cancer in mammogram when estrogen levels higher - cancers were more advanced and harder to diagnose - risk breast cancer returns to baseline after d/c Cause of Menopause: - correct answers- loss of ovarian function & subsequent hormonal deficiency - causes: * normal process of aging * surgery (total abdominal hysterectomy, bilateral oophorectomy-pushes into early menopause-no more estradiol) * chemotherapy * pelvic irradiation - postmenopausal ovary no longer produces estradiol or progesterone Combination regimens: - correct answers- estrogen given each day - progestin is added for 12-14 days: * can be combine therapy (estro+progest): more BTB assoc early on b/c giving her back her hormones - if bleeding very heavy like a period-send to PCP (possibility endometrial cancer) * can be sequential (when giving progest, there is no estrogen) Converting from Premarin dosing to Vivelle or Estrace: - correct answersPremarin 0.625mg:Vivelle 50 mcg/day Premarin 0.625 mg: Estrace 1 mg CVD and Estrogen: - correct answers- estrogen has positive effects on lipid panel - early observational studies demonstrated a decr risk of MI in patients receiving estrogen - RCTs showed incr risk in MI in patients taking estrogen+progesterone - women who initiate therapy 10 yrs after menopause may be at higher risk of CHD - estrogen therapy should not be initiated or continued for prevention of cardiac diseas