Author Question: A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having ... (Read 81 times)

newbem · **on:** Jul 24, 2018

A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness. A recent bone density study shows early osteopenia. The woman's mother had CHD.

She has no family history of breast cancer. The NP should prescribe: a. estrogen-only HT now.
b. estrogen-only HT in 5 years.
c. estrogen-progesterone HT now.
d. estrogen-progesterone HT in 5 years.

Question 2

A 50-year-old woman with a family history of CHD is experiencing occasional hot flashes and is having periods every 3 to 4 months. She asks the primary care NP about HT to relieve her symptoms. The NP should:

a. prescribe estrogen-only therapy.
b. initiate oral contraceptive pills now.
c. discuss using bioidentical HT.
d. plan to use estrogen-progesterone therapy when menopause begins.

amynguyen1221 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
HT relieves symptoms of menopause and prevents osteoporosis. When started soon after menopause, HT can reduce CHD risk. Breast cancer risk may be decreased if HT is begun 5 years after onset of menopause. This woman has a higher risk of CHD and osteoporosis, so initiating therapy now is a good option. Because she has had a hysterectomy, estrogen-only therapy is indicated.

Answer to Question 2

D
The timing hypothesis suggests that initiating HT at or very near to the time of menopause, which begins when a woman has not had a period for 12 months, reduces CHD in postmenopausal women. Estrogen-only therapy is indicated only for women who do not have a uterus. Oral contraceptive pills increase the risk of CHD. Bioidentical HT is not indicated.