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Contraception and HRT, HRT (Menopause, Hormonal Replacement Therapy) -…

- - - - IUD
      - Cu-IUD
      - LNG-IUD
- - - - Synthetic Oestrogen Ethyinylestradiol (EE)
      - Progestogens
        
        Levonorgestrel
        
        Norgestimate
        
        Desogestrel
        
        Gestodene
        
        Drospirenone
        
        Diengest
        
        Nomegestrol
        
        Deso and gesto stop you getting prego
  - - - ↓ Efficacy
    - - Reduce exposure to lamotrigine
        Decreased seizure control
- - - - UPA may reduce effectiveness of LNG and possibly other hormonal contraceptives
    - - Reduced absorption and efficacy of UPA
- - - - Vasomotor
        
        Hot flushes
        
        Night sweats
      - Mood
        
        Anxiety
        
        Depression
      - Cognitive function
        
        Congitive difficulties
      - Sleep
        
        Delayed onset
        
        Frequent wakenings
    - - Dysparenunia
        Painful sex
      - Loss of libido and sexual desires
      - Urinary urgency
      - Stress incontinenece
      - Urinary frequency
    - - Joint/ muscle pain
      - Loss of muscel mass - sarcopenia
      - Loss of bone mass - osteopenia
      - ↑ Risk of osteoporosis
  - - - Stages of menopause
      - Lifestyle changes + interventions that are helpful for general health
      - Benefits and risks of therapies for symptoms
      - Long term implications of menopause
- - - - Treat Vasomotor symptoms (VMS)
      - Treat Genitourinary symptoms (GSM)
    - - Oral
      - Transdermal 🥇
        
        Patch
        
        Gel
        
        Spray
        
        Lower risk of VTE and stroke compared to oral
      - Oestrogen or combined with progestogen
    - - Intact uterus
        
        Require progestogen to reduce risk of endometrial hyperplasia and cancer
  - - - Treatment of Genitourinary symptoms (GSM)
  - - - Intact uterus
    - - Medroxyprogesterone acetate
      - Norethisterone acetate
      - Dospirenone
      - Dydrogesterone
    - - Better risk profile than