BIOM1060 Lecture Notes - Lecture 4: Tibolone, Actaea Racemosa, Transdermal Patch
Document Summary
Permanent menstruation cessation due to ovarian follicular activity loss. Diagnosed retrospectively after 12 months of amenorrhoea. Stages: all last 180 days: pre-menopause: regular/variable cycles, perimenopause: variable cycle duration, post-menopause: hormone levels stabilise. Drug therapy options: hormone therapy, tibolone, complementary medicines (eg. phyto- oestrogens, black cohosh, red clover isoflavinoids, dietary soy, wild yam cream, don quai) Forms: oral tablet, intravaginal vaginal cream, pessary or iud, transdermal patch or gel. Oestrogens: relieve symptoms eg. oestradiol, oestrone, conjugated equine oestrogen. Progestogens: reduce risk of endometrial cancer associated with unopposed oestrogen eg. dydrogesterone, medroxyprogesterone, norethisterone. Benefits: reduces frequency and severity of hot flushes, relieves vasomotor, urogenital and musculoskeletal symptoms, low mood and sexual difficulties, and osteoporosis prevention. Adverse effects: vte, stroke, breast cancer, endometrial cancer (oestrogen-only), urinary incontinency, unscheduled vaginal bleeding, breast tenderness. Eg. isaflavones (soy beans), coumestans (clover and alfalfa sprouts), lignans (flax seeds) Reduce frequency of hot flushes without serious side-effects. Probably have beneficial effects on bone health.
