Terms & Definitions
Average age of Menopause in the US
51-52
Define first-pass hepatic metabolism.
oral E2 -> liver-> increased SHBG, increased clotting factors
Which women on MHT don't need a progestin?
status post hysterectomy
Which natural supplements decrease vasomotor symptoms?
None!
Anterior pituitary hormone that increases with menopause
Follicle Stimulating Hormone
Loss of ovarian function < 40yo
Premature Ovarian Insufficiency
Dose of estradiol that provides bone protection
ANY
200mg
YES
Age when MHT should be stopped
Individual decision
T-score of -1.0 - -2.5
Osteopenia
Explain why transdermal E2 is safer than oral E2
Avoid "first-pass" hepatic metabolism; lower VTE risk
Contraindication to use of micronized progesterone
Peanut allergy
The only FDA-approved anti-depressant that also treats vasomotor symptoms
List 2 tests you should check prior to starting MHT
Lipid profile, mammogram, BP, BMI,
Explain the "Timing Hypothesis"
MHT is safe for women <60yo and/or within 10 years of FMP
List absolute contraindications to E2 use
-Undiagnosed AUB, Active liver dz
Reason for bleeding on prometrium
Weak on the endometrium
hyaluronic acid, DHEA
Name a test to assess Cardiovascular risk prior to MHT
ASCVD Score, Prevent Score, CAC Score
conjugated equine estrogen
Name & explain the combined HT medication that protects the endometrium but does not contain a progestin
Duavee: bazedoxifene/conjugated estrogen (TSEC)
Mechanism of action of Veozah and Lynkuet
NK-R antagonists on KNDy neurons in anterior hypothalamus
Specific forms of MHT shown to increase breast cancer risk
CEE + MPA