KINE 2475 Lecture Notes - Lecture 50: Levonorgestrel, Ethinyl Estradiol, Cerebrovascular Disease

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Drug treatment of first choice: mht is most effective at alleviating moderate-severe vasomotor symptoms, mht consists of estrogen + progesterone or tissue-selective estrogen complex (estrogen/bazedoxifene) to prevent endometrial hyperplasia. If women has hysterectomy (removal of uterus), estrogen therapy is given over progestogen (as monotherapy): mild vulvovaginal symptoms can be managed with non hormonal lubricants & moisturizers. Assessing benefits & risks of systemic menopausal hormone therapy: mht is most effective for vasomotor symptoms. Transdermal mht & low-dose oral estrogens have lower risk of vte. & stroke compared to standard dose estrogens: mht is contraindicated in women with history of breast cancer. Mht-related breast cancer is associated with addition of progesterone to estrogen. Use of estrogen alone decreases risk of breast cancer. Cardiovascular disease: cv disease - coronary artery disease, stroke & peripheral vascular disease, menopause results in elevated lipid & vasomotor symptoms increases risk of cvd, mht has lower risk of chd.

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