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What is the effect on hepatic proteins and enzymes of oral hormone administration?
Increased synthesis of hepatic proteins and enzymes
What is the metabolism of systemic hormone administration?
Bypasses the GI tract and avoids 1st pass metabolism
What hormones are most appropriate for urogenital symptoms?
-Vaginal estrogen formulations
-Estrogens well absorbed from vagina
How do transdermal estradiol patches work?
Deliver estradiol to venous circulation at a continuous rate
What are potential issues with transdermal gels, emulsions and sprays?
-potential issues with washing or bathing
-transferring onto others through skin contact
-Require QD dosing
What is the most effective treatment for hot flashes?
-Decrease hot flashes by mean of 18/week
How does estrogen therapy prevent osteoperosis?
-Inhibit osteoclastic resorption
-Increase calcium absorption
-Supports survival of osteoblasts
What are approved indications of hormone therapy in the post-WHI era?
Moderate to severe vasomotor symptoms
-moderate to severe symptoms of vulvar and vaginal atrophy
-Prevention of esteoperosis
What are absolute contraindications to estrogen?
-Estrogen dependent neoplasia
-Abnormal genital bleeding
How are bioidentical hormones made?
Something to do with salivary hormone concentrations
Reality: No correlation between salivary hormone levels and tissue levels or symptoms
What is the main hormone of bioidentical hormone therapy?
-not approved in any form in the US
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