Menopausal Hormone Therapy- Lesneski

The most effective treatment to alleviate postmenopausal vasomotor symptoms (hot flashes and night sweats) is

• Estrogen therapy

• Selective estrogen-receptor modulators (SERMs)

• Testosterone therapy

• Clonidine

Which of the following CYP450 isoenzymes metabolizes both estrogen and medroxyprogesterone?

• 3A4

• 1A2

• 2D6

• All of them

Continued vasomotor symptoms in a 52-year-old postmenopausal woman with a history of hysterectomy receiving 0.3 mg of oral conjugated equine estrogens can best be managed by

• Changing to SERM

• Changing to gabapentin

• Increasing the daily dose of estrogen

• Decreasing the daily dose of estrogen

A 54-year-old postmenopausal woman is complaining of vaginal dryness, itching, and pain with intercourse. She has not had any other problems associated with menopause and has an intact uterus. Which of the following recommendations is the best treatment option that balances risks and benefits for the management of this patient’s symptoms?

• Oral conjugated estrogen + medroxyprogesterone acetate

• Transdermal estradiol + micronized oral progesterone

• Intravaginal estrogen cream + oral progestogen

• Intravaginal estrogen cream

Conjugated equine estrogen therapy alone has demonstrated to significantly increase the risk of

• Coronary heart disease

• Stroke

• Colorectal cancer

• Breast cancer

Which of the following agents would be the best option to treat moderate hot flashes in a 55-year-old woman with history of breast cancer?

• Tibolone

• Estrogen

• Paroxetine

• Progestogen

What is the first-line therapy for a 58-year-old postmenopausal woman suffering from mild genitourinary syndrome of menopause?

• Intravaginal moisturizer and lubricants

• Intravaginal estrogen cream

• Paroxetine

• Clonidine

A 52-year-old woman had a hysterectomy 6 months ago and is seeking treatment for her vasomotor symptoms. She has no significant family history. Based on the findings from the Women’s Health Initiative (WHI) extended-post intervention study, what would be the most appropriate information to provide the patient regarding menopause hormone therapy (MHT)

• Do not initiate hormone therapy now because women younger than 60 years have increased risk of coronary heart disease and stroke and have the least favorable benefit-risk profile with MHT

• Initiate hormone therapy now because women younger than 60 years have not shown an increased risk of coronary heart disease and have most favorable benefit-risk profile with MHT

• Initiate MHT later because women older than 60 years will be within the “window of opportunity” to reduce risk of breast cancer

• Initiate hormone therapy later because women older than 60 years will be within the “window of opportunity” to reduce risk of coronary heart disease

Long-term MHT can be routinely prescribed for which of the following conditions?

• Dementia unresponsive to other therapies

• Coronary heart disease

• Diabetes

• None of the above

Which of the following intravaginal estrogens is also approved for treatment of vasomotor symptoms?

• Estring (estradiol vaginal ring)

• Femring (estradiol vaginal ring)

• Femring (estradiol vaginal ring)

• Imvexxy (estradiol vaginal insert)