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Variations on a Theme Hormones In Real Life
7 year old with breast budding & leukorrhea AGE Normal or abnormal ? SEQUENCE of puberty? TIME frame? HORMONE culprit? TREATMENT options?
  16 year old with amenorrhea Age- Normal or abnormal? Sequence? Time Frame? Hormone issues? Treatment Options?
	20 year old with PMS PROGESTERONE Made by the corpus luteum Bloating/ constipation Headache Mood changes Acne Fatigue PROSTAGLANDINS Made by the endometrium Cramps Nausea/ diarrhea
     31 y/o desiring pregnancy Basics: 	Eggs 	Sperm 	Must get together 	Progesterone Tests? Treatments?
   37 y/o with irregular periods Frequency? Duration? Total Volume? Causes? Form (anatomy) Function (hormonal) Tests? Treatment Options? www.asrm.org
42 y/o with increased facial hair Pattern? Hormonal cause? Sources? Tests? Treatments?
45 y/o G4 P3 with decreased libido “Female sexual desire is highly contextual & discontinuous throughout a woman’s lifetime.  Desire and response ebb & flow & are dependent on current contextual & relationship variables, as well as historical, biographical, & hormonal factors. In contrast, male sexual desire generally remains fairly constant.”
        52 y/o with ostepenia Urogenital tissues Vagina (pH) Bladder Sexual fctn Bone loss Risk factors Treatment Hot flashes
What to DO???
Assessment and Plan for MOM Risk factors: 	Female    age>50       menopausal     smoker    low BMI 	Family history      ethnicity       corticosteroids     vitaminD EtOH (>3/d)    Prev osteoporotic fracture    RhemArth Screening: 	What?                       When? Lifestyle recommendations: 	________________________________ 	________________________________ Prevention/ Treatment: 	Estrogen   yes   no   why? _______________________ 	SERM   yes   no   why? _________________________ Bisphosphonate   yes  no why?___________________ Follow-up:_____________
Thanks !

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Rei part ii

  • 1. Variations on a Theme Hormones In Real Life
  • 2. 7 year old with breast budding & leukorrhea AGE Normal or abnormal ? SEQUENCE of puberty? TIME frame? HORMONE culprit? TREATMENT options?
  • 3. 16 year old with amenorrhea Age- Normal or abnormal? Sequence? Time Frame? Hormone issues? Treatment Options?
  • 4. 20 year old with PMS PROGESTERONE Made by the corpus luteum Bloating/ constipation Headache Mood changes Acne Fatigue PROSTAGLANDINS Made by the endometrium Cramps Nausea/ diarrhea
  • 5. 31 y/o desiring pregnancy Basics: Eggs Sperm Must get together Progesterone Tests? Treatments?
  • 6. 37 y/o with irregular periods Frequency? Duration? Total Volume? Causes? Form (anatomy) Function (hormonal) Tests? Treatment Options? www.asrm.org
  • 7. 42 y/o with increased facial hair Pattern? Hormonal cause? Sources? Tests? Treatments?
  • 8. 45 y/o G4 P3 with decreased libido “Female sexual desire is highly contextual & discontinuous throughout a woman’s lifetime. Desire and response ebb & flow & are dependent on current contextual & relationship variables, as well as historical, biographical, & hormonal factors. In contrast, male sexual desire generally remains fairly constant.”
  • 9. 52 y/o with ostepenia Urogenital tissues Vagina (pH) Bladder Sexual fctn Bone loss Risk factors Treatment Hot flashes
  • 10.
  • 11.
  • 13. Assessment and Plan for MOM Risk factors: Female age>50 menopausal smoker low BMI Family history ethnicity corticosteroids vitaminD EtOH (>3/d) Prev osteoporotic fracture RhemArth Screening: What? When? Lifestyle recommendations: ________________________________ ________________________________ Prevention/ Treatment: Estrogen yes no why? _______________________ SERM yes no why? _________________________ Bisphosphonate yes no why?___________________ Follow-up:_____________