Hormone Replacement Therapy Course

Lesson 1 • Receptor Binding and Signal Transduction

Details nuclear and membrane receptor mechanisms and downstream signalling cascades. Connects receptor pharmacology to HRT drug action.

Lesson 2 • Hormonal Feedback Regulation

Analyses negative and positive feedback axes controlling hormone levels. Establishes the regulatory logic disrupted in conditions requiring HRT.

Lesson 3 • Hormone Transport and Metabolism

Covers binding proteins, free vs. bound hormone fractions, and hepatic metabolism. Explains why transport proteins affect therapeutic dosing decisions.

Lesson 4 • Endocrine System Overview

Maps the major endocrine glands and their secretory products. Provides the anatomical baseline required for all subsequent HRT content.

Lesson 1 • Hormonal Changes in Perimenopause and Menopause

Quantifies the decline in ovarian function and resulting symptom burden. Directly motivates the clinical need for menopausal HRT.

Lesson 2 • Androgen Physiology in All Sexes

Describes testosterone and DHEA production, conversion pathways, and effects in both male and female physiology. Supports androgen therapy decision-making.

Lesson 3 • Menstrual Cycle Hormonal Dynamics

Traces FSH, LH, estradiol, and progesterone fluctuations across the cycle. Provides the hormonal reference point for diagnosing cycle-related deficiencies.

Lesson 4 • Progesterone Biology and Functions

Examines progesterone synthesis, receptor signalling, and roles in uterine protection and mood. Establishes the basis for progestogen use in combined HRT.

Lesson 1 • Laboratory Evaluation and Interpretation

Specifies hormone panels, timing of collection, and reference range interpretation. Connects lab findings to therapy initiation and monitoring decisions.

Lesson 2 • Validated Symptom Scoring Tools

Introduces standardised questionnaires for quantifying menopausal, androgen deficiency, and quality-of-life symptoms. Enables objective baseline measurement and outcome tracking.

Lesson 3 • Contraindications and Risk Stratification

Identifies absolute and relative contraindications and applies risk-scoring tools. Ensures patient safety before initiating any hormone regimen.

Lesson 4 • Indications for Hormone Replacement Therapy

Defines primary and secondary indications including menopause, hypogonadism, and surgical hormone loss. Distinguishes therapeutic from elective HRT use.

Lesson 1 • Androgen Therapy Formulations

Reviews testosterone gels, injections, pellets, and patches for male and female use. Addresses formulation-specific dosing and monitoring requirements.

Lesson 2 • Estrogen Formulations and Routes

Compares oral, transdermal, vaginal, and injectable estrogen products by pharmacokinetics and clinical effect. Guides route selection for individual patients.

Lesson 3 • Pharmacokinetics Across Delivery Routes

Applies absorption, distribution, metabolism, and excretion principles to each delivery route. Enables accurate dose prediction and adjustment.

Lesson 4 • Progestogen Formulations and Routes

Distinguishes micronized progesterone from synthetic progestins by receptor selectivity and side-effect profile. Supports safe combined HRT regimen design.

Lesson 1 • Initiating HRT: Starting Doses and Regimens

Establishes starting dose principles for estrogen, progestogen, and androgen therapies. Applies low-start, slow-titration strategy to minimise adverse effects.

Lesson 2 • Discontinuation and Tapering Strategies

Outlines evidence-based approaches to stopping HRT safely and managing withdrawal symptoms. Prepares clinicians to support patients through therapy cessation.

Lesson 3 • Cyclic, Sequential, and Continuous Regimens

Compares regimen types by bleeding pattern, endometrial protection, and patient preference. Matches regimen design to menopausal stage and uterine status.

Lesson 4 • Dose Titration and Optimisation

Guides systematic dose adjustment based on symptom response and laboratory values. Balances efficacy with the lowest effective dose principle.

Lesson 1 • Interpreting Major Clinical Trials

Critically appraises landmark HRT trials including design flaws, population differences, and updated analyses. Enables evidence-based rebuttal of outdated risk narratives.

Lesson 2 • Bone Health and Osteoporosis Prevention

Quantifies HRT's effect on bone mineral density and fracture risk reduction. Positions HRT within the broader osteoporosis prevention framework.

Lesson 3 • Cardiovascular Effects of HRT

Analyses evidence on HRT and coronary heart disease, stroke, and lipid profiles. Applies the timing hypothesis to cardiovascular risk communication.

Lesson 4 • Breast Cancer Risk Assessment

Examines absolute vs. relative risk data for estrogen-only and combined HRT. Equips clinicians to communicate breast cancer risk accurately and proportionately.

Lesson 1 • Routine Monitoring Schedule and Parameters

Defines follow-up intervals, laboratory panels, and clinical assessments for ongoing HRT management. Creates a structured safety net for long-term therapy.

Lesson 2 • Thromboembolism Risk and Prevention

Quantifies VTE risk by formulation and route and applies preventive strategies. Guides route selection and prophylaxis decisions for at-risk patients.

Lesson 3 • Endometrial Safety and Surveillance

Outlines progestogen adequacy assessment and endometrial surveillance protocols. Prevents endometrial hyperplasia and carcinoma in estrogen-treated patients.

Lesson 4 • Serious Adverse Events and Emergency Response

Prepares clinicians to recognise and respond to acute cardiovascular events, abnormal bleeding, and suspected malignancy. Ensures patient safety in urgent scenarios.

Lesson 1 • Thyroid and Adrenal Hormone Replacement

Extends HRT competency to thyroid hormone and cortisol replacement therapy principles. Addresses interactions between sex hormone and non-sex hormone replacement.

Lesson 2 • HRT After Hormone-Sensitive Cancer

Evaluates evidence and clinical guidance for HRT use in breast, endometrial, and ovarian cancer survivors. Supports nuanced shared decision-making in oncology contexts.

Lesson 3 • Premature Ovarian Insufficiency Management

Addresses the unique HRT needs of patients with POI under age 40, including higher-dose requirements and fertility concerns. Differentiates POI management from standard menopause care.

Lesson 4 • Long-Term HRT and Aging Considerations

Examines evidence for extended HRT use beyond age 60 and the evolving benefit-risk balance. Guides individualised decisions for long-term therapy continuation.