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Chapter 50. Hormone Therapy in Menopause

Which of the following statements regarding menopause is true?

A. Menopause is diagnosed after a series of increasing FSH concentrations.

B. The primary symptom of menopause is vulvovaginal atrophy.

C. Women who undergo surgical menopause experience similar vasomotor symptoms as women who undergo natural menopause.

D. The perimenopausal period is characterized by an increase in cycle interval and a decrease in cycle length.

A 48-year-old woman wants to know about the overall use of hormones based upon recent data, including WHI and HERS. The most accurate statement would be:

A. Estrogen with and without progesterone has been shown to increase heart attacks and breast cancer in postmenopausal women.

B. Estrogen and progesterone increased the risk of invasive breast cancer in postmenopausal women, but estrogen alone did not.

C. Evidence indicates topical and compounded products are safer than oral products because absorption is minimal and cardiovascular risks have not been shown to be significantly increased.

D. Evidence had demonstrated an increase in cardiovascular events in postmenopausal women who started estrogen regardless of time since initiation.

A 49-year-old woman who had a hysterectomy 6 months ago is seeking treatment for her vasomotor symptoms. Which of the following recommendations would be most appropriate?

A. Combination estrogen/progestogen for no longer than 2 years

B. Estrogen alone for no longer than 5 years

C. Estradiol vaginal cream until symptoms resolve

D. Black cohosh for no longer than 2 years

A 60-year-old woman has suffered from worsening hot flashes and urinary incontinence over the past year. Her last menstrual period was over 3 years ago. PMH is significant for hyperlipidemia taking simvastatin 40 mg daily. She smokes 1 ppd and has one glass of wine with dinner. Recommend the most appropriate treatment for this patient.

A. CEE 0.3 mg daily + MPA 1.5 mg daily

B. Venlafaxine 75 mg daily

C. CEE 0.625 mg daily

D. Estradiol vaginal cream, apply as directed

A 54-year-old postmenopausal woman presents to the clinic complaining of hot flashes. Her PMH is significant for tobacco use and ...

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