Womens Hormone Network | Assessment Test

1) The purpose of Physiologic Restoration is to reproduce the physiologic hormonal pattern of a reproductive woman in order to

a. Resolve symptoms

b. Prevent degenerative diseases of aging

c. Reduction in usage of other pharmaceutical medications

d. a. and b.

e. All of the above

2) Estradiol converts to estrone and estriol, reversibly

a. True

b. False

3) Sex hormones can be augmented (meaning, a little can be added to increase a person’s endogenous levels)

a. True

b. False

4) Dosing hormones physiologically attempts to restore the normal hormone pattern that best supports health and cellular function

a. True

b. False

5) The WHI showed that 6 years of CEE in women w/o a uterus had a 23% lower risk of breast cancer?

a. True

b. False

6) The half-life of transdermal estradiol is 6-16 hours

a. True

b. False

7) When modifying a woman’s sex hormones with physiologic restoration, adjust the estradiol to optimal levels before adjusting progesterone

a. True

b. False

8) Testosterone should be replaced only after optimal estradiol has been established

a. True

b. False

9) In the absence of the appropriate amount of progesterone receptors, progesterone hormone can cause

a. Edema

b. Weight gain

c. Blood clots

d. a and b

e. All of the above.

10) In physiologic restoration, serum blood work to assess hormone levels should be done on specific days of the dosing cycle.

a. True

b. False

11) In physiologic restoration, a “personal calendar” is for women who still cycle and the “lunar calendar” is for post-menopausal women or those who have had a hysterectomy or uterine ablation

a. True

b. False

12) If your patient is using “E2+8” dosing levels and you determine more estradiol is needed, which would be the best advice to give her:

a. increase to E2+12 BID

b. dose E2+8 TID and spread more evenly

c. increase E2 to whatever feels good

d. apply 4 twists to labia bid each dose as part of daily total

e. B & D

13) After starting a patient on Physiologic Restoration, what is the recommended first time to test hormone levels?

a. After 6 weeks

b. After 3 cycles/months

c. After 6 cycles/months

d. None of the above

e. After 1 month

14) How many hours post application is it advised to draw for serum testing?

a. It doesn’t matter

b. Within an hour

c. 2-4 hours

d. 6 hours later

15) Saliva testing can be used for Physiologic Restoration assessment?

a. True

b. False

16) The optimal range for FSH on day 3 is over 10

a. True

b. False

17) The optimal range for E2 on day 12 is dependent upon the lab range for pre-menopause women but tends to be 350-550

a. True

b. False

18) When evaluating serum labs on day 21 of dosing, is it common to see progesterone over 10ng/dL?

a. Yes, the expected range is 10-15

b. Yes, the expected range is 15-20

c. No, it is rarely seen over 10

d. It doesn’t matter what the level is

19) If a woman does not have a uterus, progesterone isn’t needed when prescribing HRT?

a. True

b. False

20) The Women’s Health Initiative (WHI) proved that hormone replacement with combined oral equine estrogen and medroxyprogesterone (MPA) may increase the risk of

a. Stroke

b. Breast cancer

c. Blood clots

d. All of the above

e) None of the above

21) Physiologic Restoration may reverse osteoporosis

a. True

b. False

22) The estradiol peak on day 12 of Physiologic Restoration

a. Creates progesterone receptors

b. Up-regulates the P53 gene

c. Creates testosterone receptors

d. All of the above

e. None of the above

23) Chronic low-estrogen (static dosing) or lack of estrogen (absent state) may lead to a loss of genomic control.

a. True

b. False

24) Static dosing of BHRT offers more prevention against coronary heart disease than Physiologic Restoration.

a. True

b. False

25) Cholesterol is needed for optimal hormone production

a. True

b. False

26) On Physiologic Restoration, the best adjustment for break-through bleeding, after day 21, is

a. Reducing total estradiol dosing

b. Increasing progesterone dosing

c. Increasing the day 12 estradiol peak on the following month

d. Adding testosterone

e. None of the above

27) Hot flashes are caused by fluctuating estrogen levels and can be stopped by

a. Increasing the progesterone

b. Adding diindolmethane (DIM)

c. Spreading out the dose of estradiol from BID to TID for 3 days

d. Decreasing the estradiol

e. Adding testosterone

28) Which of these are caused by fluctuating levels

a. Night sweats

b. Migraines

c. Anxiety

d. All of the above

e. None of the above

29) When treating with physiologic levels of estradiol, it is also a good idea to concurrently use phytoestrogen type supplements such as flax seed oil, black cohosh and dang quai to support the patient.

a. True

b. False

30) What is the healthiest duration for a woman to remain on HRT?

a. All women should be on the lowest dose of HRT to alleviate symptoms for the shortest amount of time.

b. All women should be on the lowest dose of HRT to alleviate symptoms for a maximum of 5 years.

c. All women should be on the lowest dose of HRT to alleviate symptoms and stop by 60 years of age.

d. All women should be on the lowest dose of HRT to alleviate symptoms for a year.

e. None of the above