Menopause Mastery

The literature on high estrogen dosages

1 Quiz

High Estrogen Dosages Q40

Never say “Never”

1 Quiz

Never Say “Never” Q41

Treating of Vaginal Atrophy… Oh the good you’ll do.

1 Quiz

Vaginal Atrophy Q42

Testing and Monitoring

Blood testing and the NAMS Position

1 Quiz

Blood testing & The NAMS Q43

24-hour urine hormone and salivary testing

1 Quiz

24 Hour Test Q44

Steroid Hormone Biochemistry. Roadmaps galore

1 Quiz

Steroid Hormone Q45

Risk and Estrogen Metabolites

1 Quiz

Does estrogen promote cancer growth? A Gray area re estrogen positive receptor sites and breast cancer.

1 Quiz

Estrogen & Cancer Q47

The analytes important to hormone testing

1 Quiz

Hormone Testing Q48

Understanding test results

1 Quiz

Test Results Q49

The Initial Follow-up

Crucial reasons for F/U. Questionnaires

1 Quiz

Follow-up Reasons Q50

Dialing in dosages

1 Quiz

Dialing in Dosages Q51

And now the Androgens

An androgen overview. Let’s all squeeze our anus

1 Quiz

Androgen Overview Q52

Androgen decline, Absorption, and Topical Testosterone

1 Quiz

More on Androgen Q53

Androgen Poignancies and more on Topical Testosterone

1 Quiz

Androgen Poignancies & Topical T. Q54

Risks with Androgens? Androgens Summary

1 Quiz

Risks With Androgens Q55

SHBG Sex Hormone Binding Globulin

The importance of SHBG

1 Quiz

A Method to Address Challenging Cases

Yep, there are challenging cases: Here’s a Method to address them

1 Quiz

Challenging Cases Q57

We are a No Breast Tenderness Method

How much tenderness is acceptable?

1 Quiz

Breast Tenderness Q58

Hormonal Issues of the Elderly

How much good can we do later in life?

1 Quiz

Elderly Hormonal Issues Q59

3 of 5

Androgen Overview Q52

Menopause Mastery An androgen overview. Let’s all squeeze our anus Androgen Overview Q52

NOTE: select ALL right answers! If more than one answer sounds correct to you, select them both. If three sound correct… yep, select all three!

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Question 1 of 18

1. Question
24 hour urine hormone testing assesses:
- 1) Total Testosterone
- 2) Free Testosterone
- Both are correct
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Question 2 of 18

2. Question
DHEA (Dehydroepiandrosterone):
- 1) 50% is produced in the adrenal gland (zona reticularis)
- 2) 20% is produced in the ovarian theca
- 3) 30% is derived from circulating DHEA-S
- 4) 6 – 8 mg/day are produced
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Question 3 of 18

3. Question
DHEA-S (Dehydroepiandrosterone sulphate):
- 1) Is the major product of the adrenal gland
- 2) 3.5 to 20 mg/day are produced
- 3) Serum concentrations are 72 – 186 mcg/dL
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Question 4 of 18

4. Question
DHEA is transported in the blood mainly as:
- 1) DHEA
- 2) DHEA-S
- Both are correct
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Question 5 of 18

5. Question
24 hour urine hormone testing assesses:
- 1) Free DHEA
- 2) DHEA-S
- Both are correct
Correct

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Question 6 of 18

6. Question
The principle metabolite(s) of DHEA and Testosterone are:
- 1) Androsterone
- 2) Etiocholanolone
- Both are correct
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Question 7 of 18

7. Question
DHEA:
- 1) Is the most abundant of the circulating steroid hormones
- 2) Is a precursor to production of testosterone and estrogens
- 3) Has a neuroactive effect, and thus can be one possible remedy for anxiety and depression
- 4) Acts as a full agonist of ER Beta, with a response similar to E2 and weaker than E3
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Question 8 of 18

8. Question
Androstenedione:
- 1) 50% is produced in the adrenal zona fasciculata
- 2) 50% is produced in the ovarian stroma
- 3) 1.4 – 6.2 mg are produced/day, varying with the cycle
Correct

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Question 9 of 18

9. Question
Testosterone:
- 1) Is the most potent androgen
- 2) 25% is produced in the adrenal zona fasciculata
- 3) 25% is produced in the ovarian stroma
- 4) 50% is derived from circulating androstenedione
Correct

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Question 10 of 18

10. Question
Testosterone:
- 1) 0.1 – 0.4 mg are produced each day
- 2) this compares with E2 production of 0.3 mg/day
- 3) this compares with DHEA production of 7 mg/day
Correct

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Question 11 of 18

11. Question
Testosterone is carried bound in the serum:
- 1) 69% to SHBG (Sex Hormone Binding Globulin)
- 2) 30% to SHBG (Sex Hormone Binding Globulin)
- 3) 69% to Abumin
- 4) 30% to Abumin
Correct

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Question 12 of 18

12. Question
SHBG
- 1) Declines in menopause thus free testosterone can increase
- 2) Declines in menopause thus free testosterone can decrease
- 3) Increases in menopause thus free testosterone can increase
- 4) Increases in menopause thus free testosterone can decrease
Correct

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Question 13 of 18

13. Question
SHBG:
- 1) Can be increased by oral contraceptives
- 2) Can be increased by oral estrogens
- 3) Can be increased by topical estrogens
Correct

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Question 14 of 18

14. Question
DHEA levels
- 1) May not change in the beginning of menopause
- 2) Commonly have declined to 25% of youthful levels by the beginning of menopause
- 3) May increase in the beginning of menopause
- 4) Definitely will decline in 1 – 5 years after the onset of menopause if they haven't already
Correct

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Question 15 of 18

15. Question
Testosterone levels
- 1) May not change in the beginning of menopause
- 2) May have already declined by the beginning of menopause
- 3) May increase in the beginning of menopause
- 4) Definitely will decline in 1 – 5 years after the onset of menopause if they haven't already
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Question 16 of 18

16. Question
Testosterone
- 1) When the ovary ceases functioning, can convert to estradiol in the adipose tissue
- 2) The more adipose tissue, the more conversion can take place
- Both are correct
Correct

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Question 17 of 18

17. Question
Clinical consequences of androgen deficiency
- 1) Weakness
- 2) Sarcopenia
- 3) Breast tenderness
- 4) Diminished libido
- 5) Diminished personal "drive"
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Question 18 of 18

18. Question
Clinical consequences of androgen deficiency
- 1) Sarcopenia of levator ani contributing to need for adult diapers
- 2) Sarcopenia of skeletal muscle leading to instability of stance and gait
- 3) Sarcopenia of cardiac muscle leading to congestive heart failure
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