USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

Table II-12-6. WHI–Benefit  and Risk    (Mean   Age of  63  Years)

Estrogen    and Progestin Estrogen  Only

Vaginal dryness Benefit Benefit

Hot flashes Benefit Benefit

Vasomotor   symptoms Benefit Benefit

Osteoporosis Benefit Benefit

Breast  cancer Risk No  change

Heart   disease Risk No change

Stroke Risk Risk

Estrogen can be administered by oral, transdermal, vaginal, or parenteral routes.
All routes will yield the benefits described.

Contraindications for hormone replacement therapy include personal history of
an estrogen-sensitive cancer (breast or endometrium), active liver disease, active
thrombosis, or unexplained vaginal bleeding.

deep    vein    thrombosis  (DVT).  The HT  group   also    had increased   heart   attacks

and breast  cancer, but these   were    not increased   in  the ET  group.

The most    common  current regimen is  oral    estrogen    and progestin   given

continuously.

Women   without a   uterus  can be  given   continuous  estrogen.   

All women   with    a   uterus  should  also    be  given   progestin   therapy to  prevent

endometrial hyperplasia.