Hormone replacement therapy oestrogens

The clinical problems that arise in the menopause are hot flushes, sweating, depression, decreased libido, increased risk of cardiovascular disease and osteoporosis. The latter results in increased incidence of hip, radial and vertebral fractures. Oestrogen is one factor controlling synthesis of active vitamin D and osteoporosis is in part due to a deficiency of vitamin D. Not surprisingly, to reduce these problems, administration of oestrogen is recommended (known as hormone replacement therapy or HRT). HRT reduces some of the risk factors for coronary artery disease since it reduces blood pressure and decreases the blood level of LDL-cholesterol and increases that of HDL-cholesterol. However, there is considerable debate about whether HRT increases the risk of breast or endometrial cancer. 

Oral contraceptives containing oestrogen and postmenopausal hormone replacement therapy predispose to thromboembolism (see p. 724). 

Adverse drug reactions drugs that can predispose to thrush include broad-spectrum antibiotics, corticosteroids and drugs that can affect oestrogen levels, including oral contraceptives, hormone replacement therapy, tamoxifen and raloxifene. 

Conjugated oestrogenic hormone Premarin Hormone replacement therapy 14804... 

Norman RJ, Hight IH, Rees MC. Oestrogen and progestogen hormone replacement therapy for perimenopausal and post-menopausal women Weight and body fat distribution. Cochrane Database Syst Rev 2000 CD001018. 

In therapy substitntion with oestrogens is used (hormone replacement therapy) and in phytotherapy two plants with hormonelike—but not substitntion—effects are used. 

Hormone replacement therapy (HRT) with oestrogen and progesterone is no longer recommended and should not be used as first line treatment in post-menopausal women for osteoporosis. This is because of the increased risk of breast, endometrial and ovarian cancer with HRT. Its use should be reserved for patients in whom other drugs are contraindicated, not tolerated or ineffective. HRT is most effective if started early in the menopause and continued for up to five years (after which osteoporosis will return, possibly at an accelerated rate). 

HRT hormone replacement therapy - usually with oestrogen and progesterone... 

This patient has a high serum T j because the oestrogen component of hormone replacement therapy stimulates the synthesis of thyroxine-binding globulin. Thus, to maintain a normal level of the physiologically active Free T the total serum T, needs to be increased. 

Pre-menopausal women suffer less cardiovascular disease than men do. This protection disappears, however, after the menopause, and hormone replacement therapy in post-menopausal women reduces cardiovascular mortality. Animal work suggests that oestrogens dilate blood vessels by an endothelium-dependent mechanism, but as yet there is no direct evidence to show that NO generation is different between men and women. This is an area of considerable interest, particularly as women have greater longevity than men and suffer less ischaemic heart disease. Abnormal NO production may occur in hypercholesterolaemia and may be related to subsequent development of atherosclerosis. There is now a body of experimental data to suggest that an abnormality in NO production or function may be causal, or at least an amplifying factor, in both hypercholesterolaemia and atherosclerosis. 

In addition to their use as oral contraceptives, oestrogens and progestogen, either in combination or as oestrogens only treatments, have been used as hormone replacement therapy to alleviate the problems associated with the menopause. 

Oestrogen deficiency in postmenopausal women. This leads to thinning of the endometrial tissue with increased susceptibility to irritation and trauma and cystitis-like symptoms. It can be corrected by hormone replacement or topical oestrogen therapy. Vaginal lubricants can be used if symptoms are caused by intercourse. Honeymoon cystitis may occur in younger women as a consequence of increased sexual activity. 

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