Disclosures. Objec7ves 9/9/15. What Exactly are bio- iden7cal hormones and what should I tell my pa7ents? Christy Blanco, DNP, RN, WHNP- BC.
|
|
- Patricia Baldwin
- 6 years ago
- Views:
Transcription
1 What Exactly are bio- iden7cal hormones and what should I tell my pa7ents? Christy Blanco, DNP, RN, WHNP- BC Disclosures None Objec7ves Discuss terminology of bio- iden7cal, synthe7c and natural hormones. Iden7fy the risks and benefits of hormone replacement therapy and the latest evidence about treatment of menopausal symptoms. What should you tell your pa7ents about bio- iden7cal hormones. 1
2 Menopause Cessa7on of menses for one year Average age 51 Due to cessa7on of ovarian func7on and diminished levels of estrogen 6,000 women reach menopause daily 10- year anniversary of the first report from the WHI History of HRT 1970 s- recogni7on estrogen increased uterine cancer, added proges7n to obviate risk Popularity of growing evidence might prevent coronary artery disease Animal studies suggested estrogen slowed rates of atherogenesis Epidemiologic studies found decrease risk CHD History (Con t) 1990 s CEE + MPA most widely used combina7on HT for women in the U.S. No full- scale trial with CHD as outcomes had been done HERS started early 1990s WHI started 1990 s 2
3 Before WHI A Clinical Trial of Estrogen- Replacement Therapy a]er Ischemic Stroke New England Journal of Medicine, 2001 Women s Estrogen for Stroke Trial RCT, 90 days a]er stroke or TIA Mean age 71 Background July 2002: Women s Health Ini7a7ve suspended the estrogen- proges7n trial Feb 2004: Women s Health Ini7a7ve with estrogen- only trial ended early Recommenda7ons The North American Menopause Society 2012 posi7on statement on hormone therapy. Individualiza7on is key in decision to use HT and should incorporate a woman s health and quality of life priori7es as well as her personal risk factors, such as risk of venous thrombosis, CHD, stroke, and breast cancer risk. 3
4 NAMS Recommenda7ons (con t) Recommenda7on for dura7on of therapy differs for EPT and ET. For EPT, dura7on is limited by the increased risk of breast cancer and breast cancer mortality associated with 3 to 5 years of use; for ET, a more favorable benefit- risk profile was observed during a mean of 7 years of use and 4 years of follow- up, a finding that allows more flexibility in dura7on of use. NAMS Recommenda7ons (con t) ET is the most effec7ve treatment of symptoms of vulvar and vaginal atrophy; low- doses, local vaginal ET is advised when only vaginal symptoms are present. Women with premature or early menopause who are otherwise appropriate candidates for HT can use HT at least un7l the median age of natural menopause (age 51). Longer dura7on of treatment can be considered if needed for symptom management. NAMS Recommenda7on (Con t) Although ET did not increase breast cancer risk in the WHI, there is a lack of safety data suppor7ng the use of ET in breast cancer survivors, and one RCT reported a higher increase in breast cancer recurrence rates. Both transdermal and low- dose oral estrogen have been associated with lower risks of VTE and stroke than standard doses of oral estrogen, but RCT evidence is not yet available. 4
5 WHI Women years Average age 63.6 years With uterus: mg conjugated equine estrogen mg medroxyprogesterone acetate Without uterus: mg conjugated equine estrogen WHI CHD Increase 8/10,000 year EPT Decrease 3/10,000 year ET VTE Increase 18/10,000 year EPT Increase 7/10,000 year ET Stroke Increase 8/10,000 year EPT Increase 11/10,000 year ET WHI CHD by Age- Estrogen only 5
6 Studies Problems with WHI Only one dose One form of route Different 7ming Same risk factor if you suffer from vasomotor symptoms Timing of HRT Kronos Early Estrogen Preven7on Study (KEEPS) RCT, 4 year, double blinded, placebo- controlled, low- dose oral, or transdermal estrogen and cyclic monthly progesterone Healthy women 42 to 59 (mean age of 52) Within 3 years a]er menopause 727 par7cipants, randomized to 3 groups KEEPS Trial One group 0.45 mg/ day of Premarin (conjugated equine estrogen) Second group 50 mcg of transdermal estradiol, Climara patch Third group placebo 200 mg of micronized progesterone (Prometrium) for 12 days each month 6
7 KEEPS Trial (con t) Trial did not include women with evidence of CVD Coronary artery calcium score of 50 or higher Level of plasma cholesterol or triglycerides that would normally be treated with lipid- lowering drugs Severe obesity Heavy smoking habit KEEPS Trial (Con t) Small numbers, there was a trend toward less progression of CAC in the two HT groups Neither HT significantly affected systolic or diastolic blood pressure Oral HT was associated with increase in HDL cholesterol and decrease in LDL, increased triglyceride Transdermal route improved glucose levels and insulin sensi7vity, with neutral effects on biomarkers KEEPS Trial (Con t) No sta7s7cally significant differences in rates of breast cancer, endometrial cancer, myocardial infarc7on, TIA, stroke, or venous thromboembolic disease between three groups. 7
8 Route of Administra7on Transdermal vs. oral Found many studies, no RCTs Renoux et al (2010), case control study n=59,958 Bypass hepa7c- first pass metabolism estrone Ac7vates the coagula7on cascade, increasing thrombo7c risk Cochrane Review, 2010 Cochrane review 23 studies 41,830 women 70% data from WHI, HERS 1998 Review of Literature EPT Increased risk of coronary event a]er one year 4 per 1000 Venous thrombo- embolism a]er one year 7 per 1000 Stroke a]er 3 years 18 per 1000 ET Increased risk of venous thrombo- embolism 1-2 years of use (5 per 1000) Stroke a]er 7 years (32 per 1000) 8
9 Why Worry Let s tell all women NO to hormones! They are bad They cause cancer Symptoms of Menopause Hot flashes Night sweats Vaginal dryness Anxiety Mood swings Irritability Insomnia Depression Symptoms of Menopause (con t) Loss of sexual interest Hair growth on face Painful intercourse Panic anacks Weird dreams Urinary tract infec7ons Vaginal itching Bloa7ng 9
10 Symptoms of Menopause (con t) Flatulence Indiges7on Osteoporosis Aching ankles, knees, wrists, shoulders, heels Hair loss Frequent urina7on Sore breasts Symptoms of Menopause (con t) Palpita7ons Varicose veins Urinary leakage Dizzy spells Skin feeling crawly Migraine headaches Memory lapses Weight gain Estrogens Estrogen has 400 func7ons in the body E1 called estrone E2 called estradiol E3 called estriol 10
11 Estrone (E1) Predominant estrogen in menopause Weakest of all estrogens Secreted from ovary and adipose 7ssue Estradiol (E2) 10 7mes more potent than E1 and 80 7mes more potent than estriol Predominate estrogen during reproduc7ve years Estriol (E3) 80 7mes weaker than E2, so lesser s7mulatory effect Does not have the bone, heart, or brain protec7on of estradiol Primary estrogen during pregnancy The controversy of bio- iden7cal hormone replacement therapy 11
12 Bioiden7cal What does this mean? Acts in body just like hormones we produce May be natural, but not bio- iden7cal Bio- iden7cal estradiol can be monitored and treatment individualized Synthe7c & Natural Synthe7c hormones: Not created structurally the same as human hormones Natural hormones: Not defined by FDA, however considered not ar7ficial or synthe7c (including all color addi7ves regardless of source). Estrogens Conjugated equine estrogens (CEE), Premarin Pregnant mares urine Mixture of sodium estrone sulfate and sodium equilin sulfate Sodium sulfate conjugates 17a- dihydroequilin 17a- estradiol 17B- dihydroequilin 12
13 Estrogens Synthe7c conjugated estrogens Plant based Cenes7n, Enjuivia Pills Estrogens Esterified estrogens Pregnant mare s urine Menest Pill Estrogens 17- beta- estradiol Plant based Alora, climara, esclim, estraderm, vivelle (patches) Estrogel (transdermal gel), estrasorb (topical cream), estrace (vaginal cream), estring (vaginal ring) All are bio- iden7cal 13
14 Estropipate/Plant Modified estrone Ortho- Est, Ogen (pills) Ogen (cream) Estradiol Acetate Femring Vaginal ring Bio- iden7cal Estradiol Hemihydrate Vagifem Vaginal tablet Bio- iden7cal 14
15 Ethinyl Estradiol Es7nyl Pill Progesterones Low progesterone symptoms Anxiety Depression Irritability mood swings Insomnia Decreased libido Nervousness Excessive menstrua7on Medroxyprogesterone Acetate Amen, Cycrin, Provera Pill 15
16 Micronized Progesterone Prometrium (pill) Prochieve 4% (vaginal gel) Plant- based Bio- iden7cal Norgestrel Ovrene Pill Norethindrone Micronor, Nor- QD Pill 16
17 Norethindrone Acetate Ayges7n Pill What to tell the pa7ents? Let them know what you know and let them make their own decisions It does not cause breast cancer MenoPro, free app from NAMS Ques7ons? 17
Menopause. Medicines To Help You
Medicines To Help You Menopause Use this guide to help you talk to your doctor, pharmacist, or nurse about your hormone medicines. The guide lists all of the FDA-approved products now available to treat
More informationAppendix: Reference Table of HT Brand Names
Appendix: Reference Table of HT Brand Names This is a full reference table in alphabetical order, of Brand Name drugs used in HT. It is the basis for prescription advice throughout this handbook. Drug
More informationOB/GYN Update: Menopausal Management What Does The Evidence Show? Rebecca Levy-Gantt D.O. PremierObGyn Napa Inc.
OB/GYN Update: Menopausal Management What Does The Evidence Show? Rebecca Levy-Gantt D.O. PremierObGyn Napa Inc. Napa, California IMPORTANT SAFETY INFORMATION ABOUT EVAMIST: WARNING: ENDOMETRIAL CANCER,
More informationHormone Products for Postmenopausal Use in the United States and Canada
Hormone Products for Postmenopausal Use in the United States and Canada Copyright The North American Menopause Society October 25, 2011 Table 1. Oral ET products for postmenopausal use in the United States
More informationWomen s Health: Managing Menopause. Jane S. Sillman, MD Assistant Professor of Medicine Harvard Medical School
Women s Health: Managing Menopause Jane S. Sillman, MD Assistant Professor of Medicine Harvard Medical School Disclosures I have no conflicts of interest. Learning Objectives 1. Apply strategies to help
More informationDeciding whether or not to use Hormone Therapy (HT) is a big decision and should be
Deciding whether or not to use Hormone Therapy (HT) is a big decision and should be made with input from your healthcare provider. After the decision has been made to take HT, many women don t realize
More informationBioIdentical Hormone Replacement Therapy for Women
BioIdentical Hormone Replacement Therapy for Women Bio-Identical Hormones are manufactured hormone products from soy or yam. They are changed in a laboratory so that the hormones produced are identical
More informationHRT in Perimenopausal Women. Dr. Rubina Yasmin Asst. Prof. Medicine Dhaka Dental College
HRT in Perimenopausal Women Dr. Rubina Yasmin Asst. Prof. Medicine Dhaka Dental College 1 This is the Change But the CHANGE is not a disease 2 Introduction With a marked increase in longevity, women now
More informationLearning Objectives. Peri menopause. Menopause Overview. Recommendation grading categories
Learning Objectives Identify common symptoms of the menopause transition Understand the risks and benefits of hormone replacement therapy (HRT) Be able to choose an appropriate hormone replacement regimen
More informationTURNING DOWN THE HEAT ON MENOPAUSE. Erika Schwartz, M.D.
TURNING DOWN THE HEAT ON MENOPAUSE Erika Schwartz, M.D. www.drerika.com www.bhionline.org U.S. Census Bureau, 2004 US Female Population (000 s) 100000 90000 80000 70000 60000 50000 40000 30000 20000 10000
More informationMenopausal Symptoms. Hormone Therapy Products Available in Canada for the Treatment of. Physician Desk Reference - 3rd Edition
Hormone Therapy Products Available in Canada for the Treatment of Menopausal Symptoms Physician Desk Reference - 3rd Edition A clinical resource provided to you by: The Society of Obstetricians and Gynaecologists
More informationMenopausal Symptoms The Who: Hot flashes are reported by as many as 75% of perimenopausal women in the U.S.
Menopausal Hormone Therapy: The Who, What, Where, When and Why Laurie Birkholz, MD, NCMP Knowledge of Clinical Trials Regarding Hormone Therapy and Likelihood of Prescribing Hormone Objective: The aim
More information2017 Position Statement of Hormone Therapy of NAMS: overview SHELAGH LARSON, MS, RNC WHNP, NCMP ACCLAIM, JPS HEALTH NETWORK
2017 Position Statement of Hormone Therapy of NAMS: overview SHELAGH LARSON, MS, RNC WHNP, NCMP ACCLAIM, JPS HEALTH NETWORK WHI the only large, long-term RCT of HT in women aged 50 to 79 years, Drug trail
More informationMENOPAUSE. I have no disclosures 10/11/18 OBJECTIVES WHAT S NEW? WHAT S SAFE?
MENOPAUSE WHAT S NEW? WHAT S SAFE? I have no disclosures Sara Whetstone, MD, MHS OBJECTIVES To describe risks of HT by age and menopause onset To recommend specific HT regimen for women who undergo early
More informationFOUNDATIONAL PRINCIPLES OF BIO-IDENTICAL HORMONE REPLACEMENT THERAPY: THE WHO, WHAT, WHERE, WHEN, AND WHYS. Dr. Kristy A. Prouse, MD, FRCSC (OB/Gyn)
1 FOUNDATIONAL PRINCIPLES OF BIO-IDENTICAL HORMONE REPLACEMENT THERAPY: THE WHO, WHAT, WHERE, WHEN, AND WHYS Dr. Kristy A. Prouse, MD, FRCSC (OB/Gyn) 2 HOUSEKEEPING Cell Phones Download the Slides Questions
More informationSex, hormones and the heart
Sex, hormones and the heart Dr Louise Newson BSc(Hons) MBChB(Hons) MRCP FRCGP www.menopausedoctor.co.uk #IandA2017 Declaration I have had financial relationships (lecturer, writer, member of advisory boards
More informationMenopausal Management: What Has Changed?
Menopausal Management: What Has Changed? Julia V. Johnson, M.D. Professor and Chair, OB/GYN University of Massachusetts Medical School UMass Memorial Medical Center Conflicts of Interest None Learning
More informationBenton Franklin County Medical Society 31st Annual CME Seminar
Management of Current HT/ET and SERM Recommendations Benton Franklin County Medical Society 31st Annual CME Seminar February 21, 2015 Kennewick, Washington Spokane steoporosis Dr. Lynn Kohlmeier Lynn Kohlmeier,
More informationTHE SAFETY CHECK LIST BEFORE STARTING HT
THE SAFETY CHECK LIST BEFORE STARTING HT This safety checklist was designed by the Endocrine Society in 2015 to minimize the chance of giving hormone therapy to women who may be negatively affected by
More informationCurrent Topics in Hormone Replacement Therapy
Current Topics in Hormone Replacement Therapy Corey R. Babb, D.O., FACOOG, IF, NCMP Clinical Assistant Professor of Obstetrics and Gynecology Director of the Oklahoma State University Center for Women
More informationDrug Class Review on Hormone Therapy for Postmenopausal Women or Women in the Menopausal Transition Stage
Drug Class Review on Hormone Therapy for Postmenopausal Women or Women in the Menopausal Transition Stage Final Report Update 3 October 2007 Original Report Date: February 2003 Update 1 Report Date: November
More informationPearls for Menopause Management: I m ready: now what?
Pearls for Menopause Management: I m ready: now what? Friday November 13, 2015 Susan Goldstein MD CCFP FCFP NCMP Assistant Professor Department of Family and Community Medicine University of Toronto Menarche
More informationWHI Estrogen--Progestin vs. Placebo (Women with intact uterus)
HORMONE REPLACEMENT THERAPY In the historical period it was commonly held that estrogen had two principal benefits to postmenopausal women: 1) To alleviate the constitutional symptoms related to the climacteric
More information1/11/2017. Disclosure Statement. Describe the most common medical issues associated with peri-menopause and menopause. Case study:
The Pharmacological Management of Peri-Menopause and Menopause Debora Bear, FNP, MSN, MPH University Of New Mexico Hospital Hormones and other Treatments Gwen Iffil, Stepmber 29, 19 to vember 14, 2016
More informationpresents with Ken Sekine, MD
presents Pioneering Technologies For Pellet Hormone Therapy Lifestyle Based Medicine A Primer for Clinicians with Ken Sekine, MD Dr. Sekine is a board certified OB-GYN who has been in private practice
More informationMenopause and HIV. Together, we can change the course of the HIV epidemic one woman at a time.
Menopause and HIV Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject What Is Menopause? Menopause: Point in time when a woman's menstrual periods
More informationDifference between vagifem and yuvafem
Difference between vagifem and yuvafem Generally, when estrogen is prescribed for a postmenopausal woman with a uterus, a progestin should also be considered to reduce the risk of endometrial cancer. Estrogen-alone
More informationHORMONES AND YOUR HEALTH Charlie Tucker Pharm. D
HORMONES AND YOUR HEALTH Charlie Tucker Pharm. D All of the hormones in your body are designed to work together. This is God s plan. Therefore, if one is altered, or deficient, it will affect the actions
More informationOVERVIEW OF MENOPAUSE
OVERVIEW OF MENOPAUSE Nicole Budrys, MD, MPH Reproductive Endocrinology Michigan Center for Fertility and Women s Health Presented at SEMCME March 13,2019 Objectives Define menopause Etiology of menopause
More informationHOW TO MAKE SENSE OF MENOPAUSE. by Steven. F. Hotze, M.D.
HOW TO MAKE SENSE OF MENOPAUSE by Steven. F. Hotze, M.D. INTRODUCTION Dr. Hotze is founder of Hotze Health & Wellness Center and author of the book Hormones, Health, and Happiness. He has enabled thousands
More informationEndocrine Steroids 2. Signal transduction 3. Prostaglandins
Endocrine - 2 1. Steroids 2. Signal transduction 3. Prostaglandins Estrogen Menopause (pause in the menes) ["change of life" at about 50] - lack of estrogen. (Some hysterectomy or ovarian cancer surgeries
More informationNavigating the Change: Leading Patients Through Menopause
4:30pm - 5:30pm: Breakout 5 - Women s Health Option A: Navigating the Change: Leading Patients Through Menopause ACPE UAN 0107-0000-10-025-L01-P 0.1 CEU/1.0 Hr. Activity Type: Application-Based Program
More informationA Practitioner s Toolkit for the Management of the Menopause
Medicine, Nursing and Health Sciences A Practitioner s Toolkit for the Management of the Menopause Developed by the Women s Health Research Program School of Public Health and Preventive Medicine Monash
More informationIf you would like bypass the presentation for the summary, right click on your mouse and go to slide # 138. Enjoy
Welcome This is an online version of a presentation given by Dr Keith Merritt. Its purpose is to give a balanced review of the risks, benefits and alternative treatments for the changes and symptoms of
More informationPost-menopausal hormone replacement therapy. Evan Klass, MD May 17, 2018
Post-menopausal hormone replacement therapy Evan Klass, MD May 17, 2018 Are we really still talking about this? Are we really still talking about this? 1960-1975- estrogen prescriptions doubled. Pharma
More informationJames H. Liu, M.D. Arthur H. Bill Professor Chair of Reproductive Biology Dept of Obstetrics and Gynecology
Disclosure Estrogen Therapy After Postmenopausal Hysterectomy: Issues, Challenges, Risks/Benefits James H. Liu, M.D. Arthur H. Bill Professor Chair of Reproductive Biology Dept of Obstetrics and Gynecology
More informationNorth American Menopause Society (NAMS)
North American Menopause Society (NAMS) 2012 Hormone Therapy Position Statement Cynthia B. Evans, MD Assistant Professor-Clinical Department of Obstetrics and Gynecology The Ohio State University College
More informationBioidentical hormone therapy: Clarifying the misconceptions
CURRENT DRUG THERAPY CME CREDIT EDUCATIONAL OBJECTIVE: Readers will discuss the risks and benefits of hormone therapy with their patients LYNN PATTIMAKIEL, MD, NCMP Department of Internal Medicine, Center
More informationBioidentical Hormones: Just the Facts
Bioidentical Hormones: Just the Facts Melissa McNeil, MD, MPH Professor of Medicine and Obstetrics, Gynecology and Reproductive Sciences Chief, Section of Women s Health University of Pittsburgh Disclosures!
More informationUPDATE: Women s Health Issues
UPDATE: Women s Health Issues Renee B. Alexis, MD, MBA, MPH, FACOG Associate Professor Department of OBGYN Kiran C. Patel College of Osteopathic Medicine Disclosure of Conflicts of Interest I have no financial
More informationMenopause management NICE Implementation
Menopause management NICE Implementation Dr Paula Briggs Consultant in Sexual & Reproductive Health Southport and Ormskirk NHS Hospital Trust Why a NICE guideline (NG 23) Media reports about HRT have not
More informationLessons from the WHI HT Trials: Evolving Data that Changed Clinical Practice
Lessons from the WHI HT Trials: Evolving Data that Changed Clinical Practice JoAnn E. Manson, MD, DrPH, FACP Chief, Division of Preventive Medicine Interim Executive Director, Connors Center Brigham and
More informationBy J. Jayasutha Lecturer Department of Pharmacy Practice SRM College of Pharmacy SRM University
By J. Jayasutha Lecturer Department of Pharmacy Practice SRM College of Pharmacy SRM University Cessation of menstruation as a result of the aging process of or surgical removal of the ovaries; change
More information22/09/2014. Menopause Management. Menopause. Menopause symptoms
Menopause Management Dr Sonia Davison Jean Hailes for Women s Health Menopause Time of last menstrual period - average age 51 Premature Menopause: occurs before age 40 Perimenopause (menopause transition):
More informationOhio Northern University HealthWise. Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018
Women s Health Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018 Let Your Body Empower You! National Women s Health Week Polycystic Ovary Syndrome Page 2 Breast
More informationMenopause 101. Sharzad Green, Pharm.D. Community Clinical Pharmacy
Menopause 101 Sharzad Green, Pharm.D. Community Clinical Pharmacy 1 She has such different moods. One day she is all smiles and happiness. Other days there is no living with her. Throughout a woman s life,
More informationEstrogens and progestogens
Estrogens and progestogens Estradiol and Progesterone hormones produced by the gonads are necessary for: conception embryonic maturation development of primary and secondary sexual characteristics at puberty.
More informationManaging menopause in Primary Care and recent advances in HRT
Managing menopause in Primary Care and recent advances in HRT Raj Saha, MD, DMRT, FRCOG Consultant Gynaecologist Heart of England NHS Foundation Trust rajsaha1@yahoo.co.uk Content of today s talk Aims
More informationOrals,Transdermals, and Other Estrogens in the Perimenopause
Orals,Transdermals, and Other Estrogens in the Perimenopause Cases Denise Black, MD, FRCSC Assistant Professor, Obstetrics, Gynecology and Reproductive Sciences University of Manitoba 6/4/18 197 Faculty/Presenter
More informationEstrogen and progestogen therapy in postmenopausal women
Estrogen and progestogen therapy in postmenopausal women The Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Hormone
More informationHORMONE REPLACEMENT THERAPY-UPDATE KHALED SAKHEL, MD FACOG FACS FAIUM ASSOCIATE PROFESSOR EASTERN VIRGINIA MEDICAL SCHOOL
HORMONE REPLACEMENT THERAPY-UPDATE KHALED SAKHEL, MD FACOG FACS FAIUM ASSOCIATE PROFESSOR EASTERN VIRGINIA MEDICAL SCHOOL INTRODUCTION NORMAL WOMEN HAVE MENOPAUSE AT A MEAN AGE OF 51 YEARS, WITH 95 PERCENT
More informationEstrogen (conjugated estrogens & ethinyl estradiol) Addition to the List
Estrogen (conjugated estrogens & ethinyl estradiol) Addition to the List Note: Commonly prescribed medication. Literature question Is estrogen effective and safe? Are conjugated estrogens effective and
More informationMenopause and HRT. John Smiddy and Alistair Ledsam
Menopause and HRT John Smiddy and Alistair Ledsam Menopause The cessation of menstruation Diagnosed retrospectively after 1 year of amenorrhoea Average age 51 in the UK Normal physiology - Menstruation
More information11/11/2015. Calm Your Hormones! OR EVERYTHING YOU SHOULD KNOW ABOUT HORMONE THERAPIES
Jill Earl CNM,CRNP Calm Your Hormones! OR EVERYTHING YOU SHOULD KNOW ABOUT HORMONE THERAPIES Hormone Production &Utilization LITTLE PACKAGES WITH A BIG IMPACT Key Components of Overall Health Chemical
More informationKathryn M. Rexrode, MD, MPH. Assistant Professor. Division of Preventive Medicine Brigham and Women s s Hospital Harvard Medical School
Update: Hormones and Cardiovascular Disease in Women Kathryn M. Rexrode, MD, MPH Assistant Professor Division of Preventive Medicine Brigham and Women s s Hospital Harvard Medical School Overview Review
More informationArizona Natural Medicine, L.L.C W. Ray Road, Suite 1, Chandler, AZ
MENOPAUSE: THE ROAD TO HARMONY by Dr. Sarv Varta Khalsa, N.M.D. Have you been feeling like your emotions are out of control lately? Do you feel irritable one minute, snapping impatiently at your family
More informationHer serial lab numbers are as follows: all lipid concentrations in mg/dl
LIPID CASE 267 Hormones Lipids and Lipoproteins? On to the case: I was asked about the following patient which will lead into a discussion of using menopausal hormone therapies in women with CV risk. A
More informationManaging menopause in Primary Care and recent advances in HRT
Managing menopause in Primary Care and recent advances in HRT Raj Saha, MD, DMRT, FRCOG PG Cert. Advanced Gynaecology Endoscopy Consultant Gynaecologist Heart of England NHS Foundation Trust Spire Parkway
More informationHRT & Menopause Where Do We Stand Now?
HRT & Menopause Where Do We Stand Now? Mrs. SY Hussain Consultant Gynaecologist The Holly Private Hospital Spire Roding Hospital The Wellington Hospital Discussion Points Discuss Recommendations made by
More informationHORMONE THERAPY A BALANCED VIEW?? Prof Greta Dreyer
HORMONE THERAPY A BALANCED VIEW?? Prof Greta Dreyer -- PART 1 -- Definitions HRT hormone replacement therapy HT genome therapy ERT estrogen replacement therapy ET estrogen EPT estrogen progesterone therapy
More informationSummary of the risk management plan (RMP) for Duavive (conjugated oestrogens / bazedoxifene)
EMA/679870/2014 Summary of the risk management plan (RMP) for Duavive (conjugated oestrogens / bazedoxifene) This is a summary of the risk management plan (RMP) for Duavive, which details the measures
More informationThe Estrogen Question
The Estrogen Question Hormone Therapy still offers the best relief for menopausal symptoms. Is it right for you? When 49-year-old Lee Ann Dodson heard the news that the Women's Health Initiative (WHI)
More information1405 NE Douglas Lee s Summit, MO Phone: Date: Fax: Female Information and Health Summary
Tracy Dryer, RPh Sheryl Pfeiler, Pharm D, RPh 1405 NE Douglas Lee s Summit, MO 64086 Phone: 816-524-8444 Date: Fax: 816-246-5493 Female Information and Health Summary Name Date of Birth Address City/State/ZIP
More informationHormone Replacement Therapy For Women
Hormone Replacement Therapy For Women Consultation Information www.urologyaustin.com Biological Aging and Hormones As we age, a natural degeneration and aging of organs causes the levels of our hormones
More informationDrug Class Review on Estrogen for Treatment of Menopausal Symptoms and Prevention of Low Bone Density & Fractures. Final Report
Drug Class Review on Estrogen for Treatment of Menopausal Symptoms and Prevention of Low Bone Density & Fractures Final Report Heidi D. Nelson, MD, MPH Peggy Nygren, MA Benjamin K. S. Chan, MS Produced
More informationMENOPAUSAL HORMONE THERAPY 2016
MENOPAUSAL HORMONE THERAPY 2016 Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA NICE provides the National Health Service advice on effective, good value healthcare.
More informationMenopause Matters. Equity Office Staff Seminar 14 November 2018
Menopause Matters Equity Office Staff Seminar 14 November 2018 1 What to expect at menopause How to manage symptoms Support at work Dr Janice Brown Medical lead, The University of Auckland NZ representative,
More informationControversies in Primary Care Pros and Cons of HRT on patients with CHD
Controversies in Primary Care Pros and Cons of HRT on patients with CHD Claire Bellone MSc Clinical Nurse Specialist Menopause Nottingham Declaration Honorariums & Sponsorship from Bayer, Novonortis, Wyeth
More informationMenopause Symptoms and Management: After Breast Cancer
Menopause Symptoms and Management: After Breast Cancer An Educational Webinar for Patients and their Caregivers Wen Shen, MD, MPH Division of Gynecologic Specialties July 27, 2018 1 Disclosure I have a
More informationName: Date of Birth: Age: Address: City State Zip
Today s Date: Client History Name: Date of Birth: Age: Address: City State Zip Cell Phone: Home Phone: Work Phone: Email Address: Female Male Emergency Contact: Phone Number: How did you hear about us?
More informationVirtual Mentor Ethics Journal of the American Medical Association November 2005, Volume 7, Number 11
Virtual Mentor Ethics Journal of the American Medical Association November 2005, Volume 7, Number 11 Clinical Pearl Post Women's Health Initiative Menopausal Women and Hormone Therapy by JoAnn V. Pinkerton,
More informationWhat's New in Menopause Management
Annual Review of Family Medicine December 10, 2015 San Francisco, CA What's New in Menopause Management Michael Policar, MD, MPH Clinical Professor of Ob, Gyn, and Repro Sciences UCSF School of Medicine
More informationDr. Jack Monaco Safe Solutions for Menopause
Dr. Jack Monaco Safe Solutions for Menopause The following is taken from The Future of Health Now interview conducted by Ann Wixon with menopause and hormone expert, Dr. Jack Monaco. We have compiled the
More informationManagement of Menopausal Symptoms
Management of Menopausal Symptoms Tammie Koehler DO, FACOG 1 Menopause Permanent cessation of menstruation that occurs after the loss of ovarian activity Determined to have occurred after 1 full year of
More informationPotential dangers of hormone replacement therapy in women at high risk
ESC meeting, Stockholm, August 30, 16.30-18.00, 2010 Potential dangers of hormone replacement therapy in women at high risk Karin Schenck-Gustafsson MD, PhD, FESC Professor, Chief consultant Department
More informationFinancial Conflicts of Interest
Hormone Treatment of Menopausal Women: What Are the Data Telling Us (and Not Telling Us)? S. Mitchell Harman, M.D., Ph.D. Chief, Endocrine Division Phoenix VA Health Care System Clinical Professor, Medicine
More informationData Shows Reduction in Frequency and Severity in Hot Flashes in as Early as 14 Days
Newly Published Menopause Study: Bioidentical and FDA Approved Divigel (estradiol gel) 0.1 Percent Safe and Effective Treatment for Moderate to Severe Hot Flashes Associated with Menopause Data Shows Reduction
More informationFemale New Patient Questionnaire
Patient Demographics First Name: Middle: Last Name: Home Phone: Cell Phone: Email: Address: SSN: City: State: Zip: Age: Date of Birth: Referred by: OBGYN: Occupation: Primary Care Physician: Marital Status:
More informationBefore you prescribe
Initiating hormone replacement therapy (HRT) / menopausal hormone therapy (MHT) Dr Sonia Davison Jean Hailes Consultant Endocrinologist Before you prescribe Ensure there are no contraindications to HRT/MHT
More informationBodily Conditions Rooted in Hormone Imbalance
Check this list for all conditions that apply to you. The total possible score is 209. Count the number of symptoms you check. The higher your score, the more likely you need to address hormone imbalances.
More informationConflict of Interest Disclosure. No conflict of interest to disclose
Denise Gruccio Paolucci DNP, CRNP, PNP-BC Division of Endocrinology/Diabetes Diagnostic and Research Growth Center Turner Syndrome Program The Children s Hospital of Philadelphia Conflict of Interest Disclosure
More informationReal life issues & answers: The hormonal patient Defining best practice, 5 key issues & case study
Real life issues & answers: The hormonal patient Defining best practice, 5 key issues & case study Dr Louise Newson BSc(Hons) MBChB(Hons) MRCP FRCGP www.menopausedoctor.co.uk Case Number 1 - Claire Age
More informationPatient education for transgender feminizing hormone therapy
Date name DOB Patient education for transgender feminizing hormone therapy o Some transsexual, transgender, and gender non-conforming people choose to take hormone therapy to treat gender dysphoria and
More informationTherapeutic Cohort Results
Patient: SAMPLE PATIENT DOB: Sex: MRN: Menopause Plus - Salivary Profile Therapeutic Cohort Results Hormone Average Result QUINTILE DISTRIBUTION 1st 2nd 3rd 4th 5th Therapeutic Range* Estradiol (E2) 8.7
More informationPostmenopausal women taking estrogen replacement
... CONTINUING PHARMACY EDUCATION... Hormone Replacement Therapy: Current Concerns and Considerations Dana G. Carroll, PharmD; and Sara L. Noble, PharmD AUDIENCE This activity is designed for pharmacists
More informationMs. Y. Outline. Updates of SERMs and Estrogen
Ms. Y Updates of SERMs and Estrogen Steven R. Cummings, MD, FACP San Francisco Coordinating Center CPMC Research Institute and UCSF Support from Lilly, Pfizer, Berlex 55 y.o. woman with mild hypertension
More informationPrior disclosures past 3 years Consultant for Pfizer University of Virginia received Grants/research support from TherapeuticsMD
Prior disclosures past 3 years Consultant for Pfizer University of Virginia received Grants/research support from TherapeuticsMD JoAnn V. Pinkerton, MD Professor of Obstetrics and Gynecology Director,
More informationESTROGEN For Treatment of Menopausal Symptoms and Prevention of Low Bone Density & Fractures
Oregon Health Resources Commission ESTROGEN For Treatment of Menopausal Symptoms and Prevention of Low Bone Density & Fractures This report is an update of the initial Estrogen Subcommittee Report of January
More informationSouthern California Center for Sexual Health and Survivorship Medicine Inc, Newport Beach, CA 3
The WISDOM survey: Physicians Level of Comfort Prescribing Treatment for Vulvar and Vaginal Atrophy (VVA) Symptoms in Women with a Predisposition or History of Breast Cancer Lisa Larkin, MD 1 ; Michael
More informationEstrogens and progestins: background and history, trends in use, and guidelines and regimens approved by the US Food and Drug Administration
The American Journal of Medicine (2005) Vol 118 (12B), 64S 73S Estrogens and progestins: background and history, trends in use, and guidelines and regimens approved by the US Food and Drug Administration
More informationMenopause & HRT. Rosie & Alex. Image:
Menopause & HRT Rosie & Alex Image: http://www.keepcalm-o-matic.co.uk/ Menopause The permanent cessation of menstruation for 12 months When does it happen? Average age 51 Image: Nature Medicine - 12, 612-613
More informationFemale Patient Questionnaire & History
!! Female Patient Questionnaire & History Name: Today s Date: (Last) (First) (Middle) Date of Birth: Age: Weight: Occupation: Home Address: City: State: Zip: Home Phone: Cell Phone: Work: E-Mail Address:
More informationFemale Patient Questionnaire & History
Female Patient Questionnaire & History Name: (Last) (First) (Middle) Today s Date: Home Phone: Cell Phone: Work: E-Mail Address: Primary Care Physician s Name: May we contact you via E-Mail? ( ) YES (
More informationOvarian Hormone Replacement. Maria Wolfs MD MHSc FRCPC Assistant Professor University of Toronto Endocrinology St. Michael s Hospital
Ovarian Hormone Replacement Maria Wolfs MD MHSc FRCPC Assistant Professor University of Toronto Endocrinology St. Michael s Hospital Disclosures None to declare Outline Hormones and the Menstrual cycle
More informationApples & Oranges Synthetic vs. Bio-Identical Studied Under the Nation s Greats in Hormone Therapy! Salt Lake City Dr. Neal Rouzier Orlando Dr. Sangeeta Pati Naples Dr. Daved Rosensweet And finally Dallas
More information8605 SW Creekside Place Beaverton, OR Phone: Fax: Samples Collected. Samples Received 06/21/2017
TEST RESULTS Ordering Provider: Getuwell Clinic Patient Name: Patient Phone Number: 555 555 5555 Gender Female DOB 6/9/1978 (39 yrs) Menses Status Pre-Menopausal 8605 SW Creekside Place Beaverton, OR 97008
More informationWhy do I need any hormone replacement? What is Menopause? What symptoms are treated by estrogen Injections?
1 Why do I need any hormone replacement? Women need replacement if they desire to: Delay the symptoms of aging Reverse depression and anxiety Regain libido Preserve skin and muscle tone Look younger Increase
More informationUpdate on Menopause: What s New?
Karen Carlson, MD Current Clinical Issues in Primary Care 1 Update on Mepause: What s New? Karen Carlson, M.D. Massachusetts General Hospital Harvard Medical School Our agenda: Update on new data from
More information