Assignment: Hormone Replacement Therapy Essay

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Assignment: Hormone Replacement Therapy Essay

Assignment: Hormone Replacement Therapy Essay

 

Evidence-Based Information And The Advantages And Disadvantages Associated With Heart

The mean age that women reach is about 51 years. About 95% of women across the world reach menopause between the ages of 45 years old to 55 years. Most women reach menopause naturally while others go through surgical interventions. Nonetheless, all the women in menopause will experience its side effects due to reduced estrogen levels in their body. Research shows that studies concerning cancer and hormonal balance have reached a different level. For instance, it has been proven that the estrogen that women are taking nowadays is considered to be “bio-identical” to what the ovaries produce naturally, and thus approved by the FDA (Lobo, 2017). However, hormonal replacement therapy is associated with risks of developing breast cancer, which is low (Brinton et al., 2018). Nevertheless, hormone replacement therapy is also associated with several advantages such as the reduced risk of heart disease or stroke, prevention of bone loss, and reduced menopausal symptoms guaranteeing these women better sleep and improved quality of life.

Recommendations on whether to Continue Or Discontinue Ms. Martin on HRT

Ms. Martine should discontinue hormone replacement therapy. However, for her to continue with the therapy, the regiment should be a combination of both estrogen and progestin. Women with an intact uterus, just like Ms. Martin. need progestin as part of the HRT to protect the endometrium of her uterus from malignancy or hyperplasia (Sullivan et al., 2018). Additionally, the patient has been on hormone replacement therapy for about four years, while the recommended duration is a maximum of 5 years. Consequently, the patient has a family history of breast cancer, which puts her at significant risk if she goes on with the therapy. Previous studies show that some women usually experience the vasomotor symptoms of menopause for 7.4 years on average, while it might persist in others for even more than ten years. For such women, it is recommended that they use nonhormonal therapy before restarting on hormonal-based therapy.

Alternative Treatments for Menopausal Symptoms

Several treatment options are available for the menopausal symptoms experienced by Ms. Martin. For instance, cognitive behavioral therapy inclusive of hypnosis has shown beneficial outcomes in the management of disturbed sleep and hot flashes. Consequently, the

Assignment Hormone Replacement Therapy Essay

Assignment Hormone Replacement Therapy Essay

mind-body approach can be used to reduce stress among other menopausal symptoms. For obese or overweight women, eating a healthy diet full of soy-based products and frequent exercise can help reduce the symptoms (Lobo, 2017). Soy-based foods are beneficial in reducing hot flashes. Soy contains high concentrations of daidzein, which transform to equol in the intestine. Equol is responsible for duplicating the effect of estrogen in the body upon binging to the estrogen receptors. Lastly, pharmacological agents which are non-hormonal such as selective serotonin reuptake inhibitors have been approved by the FDA to be used in the management of hot flashes (Lobo, 2017).

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Recommended Screening Tests for Ms. Martin

The recommended screening tests for women between the age of 40 to 64 years, in addition to Ms. Martin case study, are as follows (Symer et al., 2018):

  • Blood pressure screening after every two years if the reading is less than 120/80 or every year when the systolic blood pressure is between 120 to 139 mm Hg and diastolic between 80 to 89mm Hg.
  • Mammogram yearly, in addition to a clinical breast exam.
  • A Pap test plus HPV tests (co-testing) after every five years for cervical cancer screening.
  • Colorectal cancer screening by flexible sigmoidoscopy every five years and colonoscopy after every ten years (Symer et al., 2018). The patients can also undergo a double contrast barium enema after every five years. Other tests for cancer include fecal occult blood test yearly, fecal immunochemical tests yearly, or stool DNA Tests.
  • Depression
  • Diabetes Mellitus at least after every three years mainly for adults with a sustainable blood pressure of 135/80 mm Hg and no symptoms of diabetes (Symer et al., 2018).
  • Lipid disorder teste at least after every five years for all women above 45 years who are a high risk of coronary artery disease.
  • Overweight and obesity by frequently checking BMI.
  • Other routine examinations such as osteoporosis, vision, and hearing.

Health Promotion, Maintenance, and Prevention Education Important to Ms. Martin

The body, mind, and soul are supported by an appropriate health promotion, and preventive and maintenance education. I would encourage the client to adopt a healthy diet, exercise frequently and get enough sleep, which reduce the risks of developing cardiovascular diseases, stroke, osteoporosis, and diabetes mellitus (Utian & Schiff, 2018). She should also take adequate amounts of food rich in vitamin D and calcium. Her weight should be monitored closely in addition to her avoiding taking alcohol or any other drug of abuse. Lastly, the client needs to be aware of the fact that menopause causes vaginal irritations and dryness; hence the use of vaginal lubricants are necessary for maintaining comfort.

For this assignment, you will review the latest evidence based guidelines as they pertain to the case below. Discussion of the case is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, case study discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
Ms. Martin is a 55-year-old woman who has been on HRT for 4 years. HRT was prescribed because Ms. Martin was experiencing vasomotor symptoms associated with menopause. Her last mammogram was 2 years ago and last pap was 5 years ago. Ms. Martin made an appointment with her nurse practitioner to discuss discontinuing HRT after hearing and reading news reports about the dangers associated with the medication. Except for the HRT, Ms. Martin is taking no medication other than a daily vitamin. She had a tubal ligation after the birth of her third child but has had no other surgeries or history of any medical conditions. Her father had cardiovascular disease and died of a myocardial infarction at 77 years of age. Her mother was diagnosed with breast cancer at 81 years of age. Ms. Martin does not smoke and rarely drinks alcohol. She likes to work in her garden but is not involved in a formal exercise program. She has gained about 10 pounds since menopause.
Please address the following Questions in essay form.

1.What evidence-based information will you provide to Ms. Martin regarding her concerns of HRT? Discuss the advantages and risks associated with HRT.
2.What are your recommendations for Ms. Martin? Will you recommend continuing or discontinuing HRT and why?
3.What alternative treatments for menopausal symptoms will you discuss with Ms. Martin?
4.Discuss the recommended screening tests, using the latest evidence based guidelines that Ms. Martin should have.
45.What health promotion, maintenance, and prevention education would be important to provide to Ms. Martin?

Please keep language professional thank you.

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