hopeofglory87
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I'm having difficulty underdtanding the difference between HRT and OCP
I kinda think they are basically the same thing...
Is that right?
and also if they are differenct, what are the disadvantages and advantages of them?
Thanks in advance
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| nightflight1945
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As a summary :
OCP : combination of estrogen and progesterone while the dominant part is progesterone.Main use is for pregnancy prevention.So the main effect/side effects are from progesterone,e.g:decreases endometrial cancer.also its dose of est/proges is relatively high so it increases the risk of breast cancer marginally.
INCREASES: breast cancer , cervical cancer , DVT , PE , LDL(progesterone increases LDL) and probably BS in diabetics
DECREASES:endometrial cancer , ovarian cancer , PID , EP ,
HRT : The main indication is Hot flush in postmeneuposal women . the ESTROGEN component is dominant .The dose of est/prog is much lower than OCP.for women with uterus a progesterone component is added.
INCREASES: CVA , marginally breast cancer , probably MI , coagulability
DECREASES: LDL (estrogen effect) , osteoporosis and hot flushes
ONLY INDICATION:HOT FLUSHES , NOT BE USED MORE THAN 4 YEARS
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| Dragonfly
Forum Elite
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well what nightflight1945 is saying is correct but too specific! there are different regimens of OCPs (combined, progestin only, etc.) but i agree on the main points.
the biggest difference is the DOSAGE. OCPs are much higher than HRTs to overcome the active (-) feedback system of the body. main purpose : contraception + many other GYN indications.
on the other hand the main purpose of HRT is 1- relieving the postmen symptoms 2- decreasing CV and Osteoporosis risks which could be carried out with much lower dose.
nightflight1945: are you sure about OCP decreasing PID rate and increasing cervical cancer rate? can you give me a source?
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| hopeofglory87
Forum Senior
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Dragon fly and nightflight1945 Thanks! I get the idea
And Dragonfly~ I am sure that OCP decreases PID it was on UW
But I'm not sure about increasing cervix ca. but I have seen that OCP's incerase cervix ca. from NOVAK..but I don't understand why....
Also another question! Do OCP's increase CAD?
and HRT decrease CAD? is that correct? I've listened to Kaplan lecture and the doc there mentioned that HRT is used for postmenopausal women because of hot flashes but also it decreases CAD...
so does that mean the Progesterone component of OCP is resposible for CAD?
I mean HRT has Estrogen dominancy and less Progesteron...so that must mean Progesterone is responsible for CAD..??
I'm confused!!!
Please help!!
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| nightflight1945
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OCP decreases PID because it make the cervical secretions thicker and less penetrable by different organisms.
OCP increase cervical cancer , probably because using OCP is associated with less usage of condoms and so there would be increase risk of HPV and cervical trauma(it is just one hypothesis in OB-Gy texts) but it seems the exact reason is not well understood.
Because OCP is used mostly in young people it is not associated with increased CAD , however in older patients it can increase CAD , this is one reason that it should be avoided in smokers over 36.
HRT : formerly it was supposed that HRT woold decrease CAD , however recent studies have shown the HRTs that contain progestrone will increase CAD marginally , however those that contain only estrogen (that should be used only in hysterectomized ladies) do not have significant impact on CAD(neither decrease nor increase).I suppose the lectures were made before this study results.
Today the only indication of HRT is for hot flushes for usage less than 5 years. for osteoporosis we have two very good (although not still as effective as HRT) class of drugs : SERMS (raloxifen which only major problem is increasing thrombotic events) and biphosphonates (major problem is esophagitis , however new formulations are one/ month instead of one /week or injectable )
Yes , I'm completely sure about OCP and PID and Cervical CA .I will find the reference ASAP.
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| Destination
Forum Junior
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very good discussion
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| hopeofglory87
Forum Senior
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Thanks!! I completely get it noW! ^-^
So it was progestrone that increases CAD not estrogen
AND HRT does NOT decrease CAD!
Can I ask why progestrone increases the risk of CAD?
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| nightflight1945
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Actually I don't know the exact reason , however it has adverse effect on lipid profile , but It can't be the main reason.
Regards
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| hopeofglory87
Forum Senior
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I think it's estrogen that increases the risk of CAD
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| Dragonfly
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thanks guys.
it makes more sense now!
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