A 49-year-old patient comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness
The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the patient asks the nurse why she must take both hormones, the best reply is: 1. "Hot flashes respond better when replacement includes both hormones."
2. "You are having very severe symptoms, so you need more hormones replaced."
3. "There is an increased risk of tissue abnormality inside the uterus if only one is given."
4. "Your blood pressure can become elevated if only one hormone is used."
3
Rationale 1: Estrogen, not progestin, improves hot flashes and most other perimenopausal symptoms.
Rationale 2: The severity of symptoms will be considered by the physician in determining the appropriate dose for the patient.
Rationale 3: Uterine endometrial cancer risks increase if only estrogen therapy is given to a menopausal woman with an intact uterus.
Rationale 4: Estrogen therapy does not cause hypertension.
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