Quiz Q20: Orally or topically? Copy

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Question 1 of 10

1. Question
Optimal estrogen routes of administration include:
- 1) Transdermal
- 2) Transmucosal
- 3) Injectable
- 4) Oral
- 5) Sublingual
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Question 2 of 10

2. Question
Oral estrogens:
- 1) Are not completely absorbed through the intestinal lining and, thus, are partially excreted in the feces.
- 2) Are partially metabolized in the gut wall.
- 3) Are taken up by the portal vein.
- 4) 30–60% of oral estrogens delivered by the portal vein are metabolized in the liver ("first pass").
- 5) Remaining portal vein estrogens are not metabolized and are then circulated as bioavailable hormones.
- 6) Require higher dosages to result in sufficient bioavailable estrogens.
- 7) Produce remarkably elevated levels of metabolites compared to transdermal estrogens.
- 8) Place an unnecessary additional burden on commonly taxed-to-the-max liver.
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Question 3 of 10

3. Question
Oral estrogens cause an…
- 1) Increase in inflammatory proteins.
- 2) Increase in blood coagulability.
- 3) Increase in SGOT and SGPT.
- 4) Increase in steroid binding proteins, such as SHBG.
- 5) Increase in breast density.
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Question 4 of 10

4. Question
24-hour urine hormone testing:
- 1) Should be done while a woman is taking her hormones.
- 2) Gives a real-time reading of the levels of hormones that have absorbed into a woman's body.
- 3) Instructions often call for eliminating any oral hormones the night prior to and the day of sample collections.
- 4) When oral hormones are not eliminated the night before and on the day of testing, the hormone levels in the urine are often dramatically elevated.
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Question 5 of 10

5. Question
According to an article by Dr. Jonathan Wright:
- 1) The common and traditionally recommended dosage of oral estradiol is 1–2 mg/day.
- 2) Oral estradiol results in urinary excretion of estrone at values 5 to 10 times the upper limit of the reference range for premenopausal women.
- 3) Sublingual estradiol circumvents any detriments of oral estrogens.
- 4) If oral estrogens are to be used at all, dosages should not exceed 0.25 mg.
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Question 6 of 10

6. Question
Which one is false:
- Oral estrogen in common dosages can raise the SHBG
- Oral estrogen in common dosages can lower the SHBG
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Question 7 of 10

7. Question
Commonly used oral doses of estradiol can create estrogen levels on 24 hour urine hormone tests…
- that are insufficient to protect bones and vagina
- that are astronomically high and pose a risk
- as well as estrogen metabolite levels that tend to be way out of optimal range
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Question 8 of 10

8. Question
Transdermal estrogens as the route of administration…
- are superior as first pass effects from oral administration can be source of adverse estrogen effects.
- have no "first pass" effect thus can be administered in significantly lower dosages
- tend to absorb excellently
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Question 9 of 10

9. Question
First pass impacts:
- hepatic protein production including increases in C-reactive protein, Insulin like growth factor, and clotting factors
- hepatic protein production including increases in Sex Hormone binding globulin, thyroxine binding globulin, cortisol binding globulin
- adversely lipids, cardiovascular functions, inflammatory and thrombotic mechanisms, insulin resistance, and weight control
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Question 10 of 10

10. Question
Compounded topical Bi-est & Progesterone resulted in favorable outcomes for
- cardiovascular biomarkers
- inflammatory factors
- immune signaling factors
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Menopause Mastery (The Institute of Bioidentical Medicine) Copy

Quiz Q20: Orally or topically? Copy

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