A 50-year-old woman presents with symptoms of menopause including hot flashes, irritability, and insomnia for the past year since attaining menopause. Her BMI is 26 and she has no other risk factors. The woman's problem is likely menopause symptoms due to estrogen deficiency. The plan would be to discuss hormone replacement therapy (HRT) options with her to relieve her menopause symptoms. HRT replaces estrogen that declines during menopause.

1. A 50 year old women presents with history of hot
flushes ,irritability and insomnia. She attained
menopause 1 year ago. Her BMI is 26 and there are no
other risk factors?
 What do you think her problem is????????????
 What is YOUR plan next?
Case scenario
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2. Hormone Replacement Therapy
DR.RUPAL
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3. Hormone replacement therapy (HRT) is a treatment
used to relieve symptoms of the menopause. It
replaces female hormone(estrogen)that is at a lower
level as you approach the menopause.
What is HRT?
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4.  Symptomatic women who suffer from oestrogen
deficiency.
 High risk cases of menopausal complications such as
cardiovascular disease, osteoporosis, stroke,
Alzheimer’s disease and colonic cancer
 Premature menopause(spontaneous/post surgery)
 Gonadal dysgenesis (therapeutic)
 Women demanding HRT as prophylaxsis.
WHO NEEDS HRT?
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5.  ESTROGEN
 PROGESTERONE
 TIBOLONE
 RALOXIFENE
 BISPHOSPHONATES
 SOYA
 ANDROGENS
DRUGS USED IN HRT
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6. ESTROGEN
1. ORAL
2. TRANDERMAL
3. IMPLANTS
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7. 7

8. 4.VAGINAL
5. INJECTABLE CEE
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9.  ORAL
 INTRAMUSCULAR INJECTION
 IMPLANTS
 IUCD
 VAGINAL TABLETS AND RINGS
 SKIN PATCHES
PROGESTERONE
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10. 10

11. TIBOLONE
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12. SERM
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13. ANDROGENS
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14. 14

15. SHORT TERM LONG TERM
HOT FLUSHES OSTEOPOROSIS
VASOMOTOR SYMPTOMS CARDIOVASCULAR DISEASE
DYSPAREUNIA, LIBIDO ALZHEIMER’S DISEASES
URETHRAL SYNDROME
USES OF HRT
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16. RISKS OF HRT
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17. HOW TO START
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18. OLDER WOMEN
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19. MONITORING
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20. TIME OF CEASING
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21. THANK YOU
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