Menopause Mastery

21. The importance of Estriol (E3) and an introduction to receptor sites.

1 Quiz

Quiz 21: Importance of Estriol

22. Prescribing Bi-est: Understanding the E3/E2 ratio. “mgeeq”: the oh-so-important math on potencies and ratios.

1 Quiz

Quiz 22: Potencies and Ratios

23. Calculating Bi-Est potency

1 Quiz

Quiz 23: Calculating Potencies and Ratios

24. All about bases

1 Quiz

25. Individualization. Dose Determination by titration. Receptor site sensitivity and dormancy.

1 Quiz

Quiz 25: Sensitivity and Dormancy

26. Aiming for optimum: balancing drops, concentrations and ratios.

1 Quiz

Quiz 26: Optimum Doses

27. Window of Opportunity: Cardiovascular Risk Considerations

And now we're on to Progesterone!

28. Treat early on!

1 Quiz

Quiz 27: Treating Early

29. The effect on Thyroid, Bone, Sleep and Brain

1 Quiz

Quiz 28: The Effects

30. Breast Cancer risk, SHBG issues.

1 Quiz

Quiz 29: Progesterone Problems

31. Progesterone Poignancies. Transdermal dosage limits. Dermal Fatigue. TVUS.

1 Quiz

Quiz 30: Progesterone and Optimal Dosing

32. Excessive Progesterone Dosages: receptor sites. Unusual Symptoms

1 Quiz

Quiz 31: Unusual Symptoms

33. Common Starting Dosages

1 Quiz

Quiz 32: Starting Dosages

Progesterone. Prescribing and applying Bi-Est and Progesterone: Prescription

34. Writing Your First Prescription. Four Distinct Dosing Schedules in the Dose Determination Process.

1 Quiz

Quiz 33: First Prescription

35. Topical hormone application: the how and the when for Bi-est and progesterone.

1 Quiz

Quiz 34: Topical Hormone Applications

36. Topical hormone application: Absorption, dermal fatigue, transmucosal and transmission

1 Quiz

Quiz 35: More on Application

Getting to right-dose

37. Some important factors

1 Quiz

Quiz 36: Important Factors

38. Optimal dose ranges

1 Quiz

Quiz 37: Ranges

39. Variations in Total Potent Estrogens

1 Quiz

Quiz 38: Variations

40. Supra-physiologic dosages… watch out!

1 Quiz

Quiz 39: Supraphysiologic Dosages

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Quiz 22: Potencies and Ratios

Menopause Mastery 22. Prescribing Bi-est: Understanding the E3/E2 ratio. “mgeeq”: the oh-so-important math on potencies and ratios. Quiz 22: Potencies and Ratios

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 8

1. Question
Which of the following are true of estrogen potency?
- E3 is 1/8th as potent as E2
- E3 is 0.125x as potent as E2
- E2 is 8x as potent as E3
- All of the above
- None of the above
Correct

Incorrect
Question 2 of 8

2. Question
Which of the following is the most commonly and initally prescribed Bi-est E3/E2 ratio that will ultimately result in optimal EQ on testing?
- E3:E2 of 80:20
- E3:E2 of 50:50
- E3:E2 of 30:70
Correct

Incorrect
Question 3 of 8

3. Question
The final choice of E3/E2 ratio should be based on which of the following? Select all that apply.
- The patient's preference
- The EQ in the 24 hour urine hormone test
- The 2OH to 16aOH ratio
Correct

Incorrect
Question 4 of 8

4. Question
Estriol amount in your Bi-est formulation can be excessive and by the chemistry law of “mass action” lead to which of the following? Select all that apply.
- Elevated levels of 16aOH thus a decreased 2OH/16aOH ratio, less than desirable
- Elevation of estrone, thus an elevated E1/E2 ratio
- Decrease in E2
Correct

Incorrect
Question 5 of 8

5. Question
Bi-est ratio formulation should optimally result in an EQ that is between 2 and 4, thus a prominence of E3 and deproliferation, if…
- There is excellent clinical alleviation of symptoms
- The 2OH/16aOH ratio is optimal
- The TPE's are within optimal range of 8 – 14 mcg/24h
- All of the above
- None of the above
Correct

Incorrect
Question 6 of 8

6. Question
Which of the following statements about “mgeeq” is FALSE?
- It is an abbreviation of "milligrams for estradiol equivalence"
- It represents the mg of estradiol in a Bi-est formulation
- It ultimately describes the potency of Bi-est in terms of comparing it to the potency of pure E2
Correct

Incorrect
Question 7 of 8

7. Question
Which of the following statements regarding Bi-est prescriptions are correct?
- We always prescribe a 30 mg/ml 80:20 initial prescription
- It is common for the mg/ml to change by the end of the first or second month of dose titration, ultimately changing to a two drops in a.m., 3 drops in p.m. regimen
- Multiple ratios are possible other than 80:20 and might be changed but only after 24 hour urine hormone test results would indicate that need
- All of the above
- None of the above
Correct

Incorrect
Question 8 of 8

8. Question
1 mg of Bi-est is:
- Equivalent in strength to 1 mg of estradiol
- Not equivalent in strength to 1 mg of estradiol
- Is twice as strong as 1 mg of estradiol
Correct

Incorrect

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