05-10-2007, 10:57 AM
Benefits of estrogen replacement therapy {unopposed without progestin}
Conventional doses >.625mg/d
1. Decreased the risk of breast cancer.
2. Reduced the number of hip fractures
3. Lower risk of developing diabetes.
4. Lower the serum levels of atherogenic lipoprotein [A] with or without cycled progestins.
5. Improvement in HDL is greatest but is not seen in with addition of progestins
6. Eliminates or improves post menopausal hot flashes and diaphoretic episodes.
7. Libido is enhanced.
8. Sleep disturbance is improved, improve the body pain and reduced the physical function
experienced at the time of menopause.
9. Perimenopausal related depression is improved but addition of progestins negates this effect.
10. Estrogen replacement at the time of menopause or oophorectomy help protect cognitive
function, particularly verbal memory but if replacement is done years after menopause it
confers little or no effect on cognition.
11. Improves glycemic control in patients with type 2 DM
Risks of estrogen replacement therapy {unopposed without progestin}
1. Increases the risk of endometrial hyperplasia and DUB.
2. Increases the mortality risk from ovarian cancer..
3. Increases the risk of DVT.
4. It causes hypertriglyceridemia particularly in women with preexisting hyperlipidemia, rarely resulting in pancreatitis.
3& 4can be avoided by using non oral estrogen replacement.
5. Elderly women experience increased risk of urinary incontinence..
6. Some women may complain of edema and mastalgia..
7. Lower seizure threshold in some women with epilepsy.
8. Untreated large pitituary prolactinomas may enlarge if exposed to estrogen.
Risks of estrogen replacement with a progestin {combined HRT}
1. Increased risk of M. mostly in women with high LDL levels and preexisting CAD.
2. Increases breast density and increases risk of abnormal mammograms. There is also high risk of breast cancer which is not found with estrogen only treatment. It is especially increased in women who are thin with low BMI. No increased risk of breast cancer seen in women who have benign breast mass or a family history of breast cancer.
3. Increased risk of severe dementia.
4. Increased risk of developing asthma.
5. Progestins may cause moodiness,, may trigger migraines, breast tenderness, alopecia
and fluid retention
6. Do not experience increased risk of Ovarian cancer.
Conventional doses >.625mg/d
1. Decreased the risk of breast cancer.
2. Reduced the number of hip fractures
3. Lower risk of developing diabetes.
4. Lower the serum levels of atherogenic lipoprotein [A] with or without cycled progestins.
5. Improvement in HDL is greatest but is not seen in with addition of progestins
6. Eliminates or improves post menopausal hot flashes and diaphoretic episodes.
7. Libido is enhanced.
8. Sleep disturbance is improved, improve the body pain and reduced the physical function
experienced at the time of menopause.
9. Perimenopausal related depression is improved but addition of progestins negates this effect.
10. Estrogen replacement at the time of menopause or oophorectomy help protect cognitive
function, particularly verbal memory but if replacement is done years after menopause it
confers little or no effect on cognition.
11. Improves glycemic control in patients with type 2 DM
Risks of estrogen replacement therapy {unopposed without progestin}
1. Increases the risk of endometrial hyperplasia and DUB.
2. Increases the mortality risk from ovarian cancer..
3. Increases the risk of DVT.
4. It causes hypertriglyceridemia particularly in women with preexisting hyperlipidemia, rarely resulting in pancreatitis.
3& 4can be avoided by using non oral estrogen replacement.
5. Elderly women experience increased risk of urinary incontinence..
6. Some women may complain of edema and mastalgia..
7. Lower seizure threshold in some women with epilepsy.
8. Untreated large pitituary prolactinomas may enlarge if exposed to estrogen.
Risks of estrogen replacement with a progestin {combined HRT}
1. Increased risk of M. mostly in women with high LDL levels and preexisting CAD.
2. Increases breast density and increases risk of abnormal mammograms. There is also high risk of breast cancer which is not found with estrogen only treatment. It is especially increased in women who are thin with low BMI. No increased risk of breast cancer seen in women who have benign breast mass or a family history of breast cancer.
3. Increased risk of severe dementia.
4. Increased risk of developing asthma.
5. Progestins may cause moodiness,, may trigger migraines, breast tenderness, alopecia
and fluid retention
6. Do not experience increased risk of Ovarian cancer.