DR FARIHA FAROOQ

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HORMONE REPLACEMENT THERAPY

• DR FARIHA FAROOQ
• F.C.P.S
• CONSULTANT GYNAECOLOGIST
• FAOOQ HOSPITAL LAHORE-PAKISTAN

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INDICATIONS

• MENOPAUSE
• CLIMECTERIC
• OSTEOPOROSIS
• CARDIOVASCULAR
• PRE MATURE MENOPAUSE

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MENOPAUSAL SYMPTOMS

• PHYSICAL
• PSYCHOLOGICAL

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PSYCHOLOGICAL SYMPTOMS

• DEPRESSION
• IRRITABILITY
• TIREDNESS / POOR SLEEP
• ANXIETY
• LOSS OF LIBIDO
• WEEPINESS
• FORGETFULNESS
• LOSS OF CONCENTRATION

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PHYSICAL SYMPTOMS

• IRREGULAR PERIODS
• HOT FLUSHES
• NIGHT SWEATS
• PALPITATIONS
• SEXUAL CHANGES
• SKIN HAIR
• JOINT PAINS
• URINARY SYMPTOMS
• WEIGHT GAIN
• HEADACHE

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LONG TERM MENOPAUSAL EFFECTS

• ATROPHY OF VAGINA/ URETHRA
• OSTEOPOROSIS
• CARDIOVASCULAR DISEASE

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HORMONES/DRUGS INHRT

• NATURAL ESTROGENS
• PROGESTOGENS
• TIBOLONE
• RALOXIFENE(SELECTIVE ESTROGEN RECEPTOR
  MODULATORS)

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ROUTS OF T/M

• ORAL
• TRANSDERMAL
• IMPLANTS
• VAGINAL CREAMS PESSARIES

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STRATEGIES OF T/M
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T/M OF PRE-MENOPAUSAL WOMEN
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RISKS OF UNOPPOSED ESTROGENS

• ENDOMETRIAL HYPER PLASIA
• ADENOCARCINOMA
• INCREASED RISK OF Ca BREAST
• 2-4FOLD INCREASED RISK OF
• DEVELOPING THROMBOLIC
  DISEASE

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RISKS OF PROGESTOGENS

• DEPRESSION
• WEIGHT GAIN
• BLOATING
• ADVERSE AFFECT ON SERUM
• LIPIDS

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CONTRAINDICATIONSOF HRT

• PREVIOUSTHROMBOEMBOLIC DISEASE
• IMPAIRED LFT/ LIVER DISEASE
• Ca BREAST
• Ca ENDOMETRIUM
• FIBROIDS ENDOMETRIOSIS(relative)
  HYPERTENTION,DIABETES,CARDIO-VASCULAR DISEASE ARE
  NOT C/I