HORMONE REPLACEMENT THERAPY 2

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  • One-year treatment with hormone replacement therapy influenced favorably a number of prognostic cardiovascular risk factors in healthy women. The most important effect was the lowering of fibrinogen. Furthermore, in this study the effect of hormone replacement therapy on hemostasis did not deviate between a cyclic estrogen/sequential progestogen regimen and a continuous estrogen/sequential progestogen regimen. (Am J Obstet Gynecol 1999;180:283-9.)
  • HORMONE REPLACEMENT THERAPY 2

    1. 1. DR FARIHA FAROOQ F.C.P.S CONSULTANT GYNAECOLOGIST FAOOQ HOSPITAL LAHORE-PAKISTAN HORMONE REPLACEMENT THERAPY
    2. 2. INDICATIONS <ul><li>MENOPAUSE </li></ul><ul><li>CLIMECTERIC </li></ul><ul><li>OSTEOPOROSIS </li></ul><ul><li>CARDIOVASCULAR </li></ul><ul><li>PRE MATURE MENOPAUSE </li></ul>
    3. 3. MENOPAUSAL SYMPTOMS <ul><li>PHYSICAL </li></ul><ul><li>PSYCHOLOGICAL </li></ul>
    4. 4. PSYCHOLOGICAL SYMPTOMS <ul><li>DEPRESSION </li></ul><ul><li>IRRITABILITY </li></ul><ul><li>TIREDNESS / POOR SLEEP </li></ul><ul><li>ANXIETY </li></ul><ul><li>LOSS OF LIBIDO </li></ul><ul><li>WEEPINESS </li></ul><ul><li>FORGETFULNESS & </li></ul><ul><li>LOSS OF CONCENTRATION </li></ul>
    5. 5. PHYSICAL SYMPTOMS <ul><li>IRREGULAR PERIODS </li></ul><ul><li>HOT FLUSHES </li></ul><ul><li>NIGHT SWEATS </li></ul><ul><li>PALPITATIONS </li></ul><ul><li>SEXUAL CHANGES </li></ul><ul><li>SKIN & HAIR </li></ul><ul><li>JOINT PAINS </li></ul><ul><li>URINARY SYMPTOMS </li></ul><ul><li>WEIGHT GAIN </li></ul><ul><li>HEADACHE </li></ul>
    6. 6. LONG TERM MENOPAUSAL EFFECTS <ul><li>ATROPHY OF VAGINA/ URETHRA </li></ul><ul><li>OSTEOPOROSIS </li></ul><ul><li>CARDIOVASCULAR DISEASE </li></ul>
    7. 7. HORMONES/DRUGS IN HRT <ul><li>NATURAL ESTROGENS </li></ul><ul><li>PROGESTOGENS </li></ul><ul><li>TIBOLONE </li></ul><ul><li>RALOXIFENE( SELECTIVE ESTROGEN RECEPTOR MODULATORS) </li></ul>
    8. 8. ROUTS OF T/M <ul><li>ORAL </li></ul><ul><li>TRANSDERMAL </li></ul><ul><li>IMPLANTS </li></ul><ul><li>VAGINAL CREAMS & PESSARIES </li></ul>
    9. 9. STRATEGIES OF T/M
    10. 10. T/M OF PRE-MENOPAUSAL WOMEN
    11. 11. RISKS OF UNOPPOSED ESTROGENS <ul><ul><ul><ul><li>ENDOMETRIAL HYPER PLASIA </li></ul></ul></ul></ul><ul><ul><ul><ul><li>ADENOCARCINOMA </li></ul></ul></ul></ul><ul><li>INCREASED RISK OF Ca BREAST </li></ul><ul><li>2-4FOLD INCREASED RISK OF </li></ul><ul><li>DEVELOPING THROMBOLIC DISEASE </li></ul>
    12. 12. RISKS OF PROGESTOGENS <ul><li>DEPRESSION </li></ul><ul><li>WEIGHT GAIN </li></ul><ul><li>BLOATING </li></ul><ul><li>ADVERSE AFFECT ON SERUM </li></ul><ul><li>LIPIDS </li></ul>
    13. 13. CONTRAINDICATIONS OF HRT <ul><li>PREVIOUSTHROMBOEMBOLIC DISEASE </li></ul><ul><li>IMPAIRED LFT/ LIVER DISEASE </li></ul><ul><li>Ca BREAST </li></ul><ul><li>Ca ENDOMETRIUM </li></ul><ul><li>FIBROIDS &ENDOMETRIOSIS(relative) HYPERTENTION,DIABETES,CARDIO-VASCULAR DISEASE ARE NOT C/I </li></ul>

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