What is hormone replacement therapy?

It is treatment that replaces the oestrogen the ovaries no longer produce, in order to relieve the symptoms and consequences of the menopause.

Give three benefits of hormone replacement therapy.

It relieves hot flushes and night sweats, it relieves vaginal dryness and urogenital symptoms, and it preserves bone density so that fewer fractures occur.

Why does hormone replacement therapy reduce the risk of fracture?

Restoring oestrogen restrains osteoclast activity again, so the rate of bone resorption falls back towards the rate of deposition and bone density is maintained rather than lost.

Give three disadvantages or risks of hormone replacement therapy.

Combined preparations carry a small increase in breast cancer risk that grows with duration of use, there is an increased risk of venous thrombosis and of stroke, and side effects such as breast tenderness and irregular bleeding are common.

Why may a skin patch be preferred to a tablet for a woman at risk of thrombosis?

Oestrogen absorbed through the skin passes into the general circulation without first going through the liver, so it does not increase the liver's output of clotting factors in the way an oral dose does and the risk of thrombosis is much lower.

OCR A-Level Biology B H422

The Developing Cell: Cell Division and Cell Differentiation

Topic overview The cell cycle and mitosis Apoptosis in growth and repair Stem cells and cell differentiation

The Developing Individual: Meiosis, Growth and Development

Topic overview Meiosis, haploid gametes and genetic variation The stages of meiosis Antenatal care and diet in pregnancy Alcohol, smoking and monitoring fetal growth Prenatal screening and karyotypes

The Development of Species: Evolution and Classification

Topic overview Classification and the species concept Evidence for classification and DNA barcoding Phylogenetic trees, hominids and the evolution of language Human adaptations, natural selection and evolution Plant adaptations and how they are investigated Measuring biodiversity and genetic diversity

Cells and Microscopy

Topic overview Microscopy and the cell theory Blood smears, staining and microscope drawings Blood cells and their structure Magnification and measuring cells Haemocytometer cell counts and dilutions Flow cytometry in blood analysis Ultrastructure of the animal cell Plant and prokaryotic cells Membrane lipids and the fluid mosaic model Movement of molecules across membranes The roles of membranes and the secretion of proteins

Water and Its Importance in Plants and Animals

Topic overview The properties of water Water as a transport medium and the composition of body fluids Detecting and measuring sugars and proteins Monomers, polymers and the carbohydrates Osmosis and water potential

Proteins and Enzymes

Topic overview Amino acids, peptide bonds and chromatography Globular protein structure: enzymes and haemoglobin Enzyme action and the rate of reaction Blood clotting and first aid Enzymes and inhibitors in medicine Blood donation and stored blood products

Nucleic Acids

Topic overview Nucleotides, ADP and ATP The structure of DNA and its extraction DNA replication and the genetic code RNA, transcription and translation

Patterns of Inheritance

Topic overview Monogenic inheritance and genetic terminology Gene mutations and inherited disease Codominance, multiple alleles and linkage Model organisms, dihybrid crosses and the chi-squared test Chromosome mutations and genetic counselling

Population Genetics and Epigenetics

Topic overview Natural selection, sickle cell and malaria The Hardy-Weinberg principle Genetic drift, the founder effect and speciation Epigenetics and gene expression

Gene Technologies

Topic overview Post-Transcriptional Editing of mRNA Genetic modification of bacteria and insulin production The polymerase chain reaction and gel electrophoresis Haplotypes, SNPs, VNTRs and genetic engineering in eukaryotes Gene therapy and RNA interference

The Principles and Importance of Homeostasis

Topic overview Homeostatic principles, normal ranges and feedback The nervous and hormonal control of heart rate The control of body temperature and the role of thyroxine Measuring core body temperature, hypothermia and hyperthermia

The Hormonal Control of Blood Glucose and the Management of Diabetes

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Kidney Functions and Malfunctions

Topic overview Excretion and the gross structure of the kidney The nephron: ultrafiltration and selective reabsorption Investigating the composition of urine, plasma and filtrate Osmoregulation and the action of ADH The kidney as an endocrine gland and kidney failure Dialysis, transplantation and the future of transplant surgery

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Respiratory Diseases and Treatment

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Cellular Respiration

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Metabolism and Exercise

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Pathogenic Microorganisms

Topic overview How pathogens cause communicable disease Tuberculosis HIV, AIDS and the structure of the virus Identifying bacteria: Gram staining and culture Epidemiology: incidence, prevalence and mortality Notifiable diseases and the control of HIV and TB

The Immune System

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Controlling Communicable Diseases

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Photosynthesis, Food Production and Management of the Environment

Topic overview Chloroplast ultrastructure and photosynthetic pigments The light-dependent stage of photosynthesis The Calvin cycle Investigating the factors affecting photosynthesis The Hill reaction and DCPIP Using TP and GP to build carbohydrates, lipids and amino acids The compensation point and crop production Microorganisms, the nitrogen cycle and biosensors Biomass transfer and efficiency in food production Ruminants in the human food chain Farms as ecosystems and the conflict with conservation Deflected succession and measuring biodiversity

The Impact of Population Increase

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Planning and Implementing Practical Work

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Practical Skills, Apparatus and Techniques

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Fertility and Assisted Reproduction

Topic overview The urinogenital systems and gonad histology Gametogenesis and the structure of the gametes Hormonal control of gametogenesis and the menstrual cycle Fertilisation and pregnancy testing The causes and issues of infertility Assisted reproduction techniques

The Effects of Ageing on the Reproductive System

Topic overview Ageing and the female reproductive system Managing the menopause Ageing and the male urinogenital system

Plant Reproduction

Topic overview The control of flowering Adaptations of flowers for pollination Fertilisation, seed formation and germination Cereals as staple foods

The Nervous System and the Identification and Consequences of Damage

Topic overview Organisation of the nervous system and nervous tissue The structure and function of the human brain The structure of motor, sensory and relay neurones Resting potential and the action potential Synapses and the integration of responses Reflexes, reaction times and their investigation Brain scans and the consequences of nervous system damage Drugs, brain function and dependency

Monitoring Visual Function

Topic overview The structure of the eye The retina and its role as a transducer Assessing visual function by routine eye tests

The Effect of Ageing on the Nervous System

Topic overview Alzheimer's disease: symptoms and causes The effects of ageing on the senses and memory Investigating ageing, reaction times and memory

The Heart and Monitoring Heart Function

Topic overview The need for a mass transport system Structure and dissection of the mammalian heart The cardiac cycle Initiation and coordination of the heartbeat Heart rate, pulse rate and cardiac output Electrocardiograms and emergency cardiac treatment

Transport Systems in Mammals

Topic overview The closed double circulatory system Blood vessels and their microscopic structure Tissue fluid and capillary exchange Measuring and interpreting blood pressure

Gas Exchange in Mammals and Plants

Topic overview Tissues of the mammalian gas exchange system Gas exchange in the alveoli Pulmonary ventilation and lung volumes Expired air resuscitation Gas exchange and stomata in terrestrial plants

Transport Systems in Plants

Topic overview The need for transport systems in plants Vascular tissue in roots, stems and leaves Water uptake and movement through the plant Transpiration and Its Measurement Translocation in the Phloem

The Effects of Ageing on the Reproductive System

Managing the menopause

3 things to know
Components 01, 02 and 03

Overview

Recall questions on what hormone replacement therapy involves, why a progestogen is added, its benefits and risks, patches versus tablets, non-hormonal and behavioural alternatives, and phytoestrogens.

What you need to know

Answer each one before you reveal it.

Your recallNot started

Key term

Why is the decision to take hormone replacement therapy described as a balance of risk and benefit?

Key term

Give one difficulty with relying on phytoestrogen supplements.

Key term

Why is a progestogen given alongside oestrogen to a woman who still has a uterus?

Questions from this subtopic

Each one with the model answer underneath.

1
What is hormone replacement therapy?
Model answer
It is treatment that replaces the oestrogen the ovaries no longer produce, in order to relieve the symptoms and consequences of the menopause.
2
Why is a progestogen given alongside oestrogen to a woman who still has a uterus?
Model answer
Oestrogen on its own makes the endometrium proliferate continuously, which raises the risk of endometrial hyperplasia and cancer, and adding a progestogen opposes that proliferation.
3
Give three benefits of hormone replacement therapy.
Model answer
It relieves hot flushes and night sweats, it relieves vaginal dryness and urogenital symptoms, and it preserves bone density so that fewer fractures occur.
4
Why does hormone replacement therapy reduce the risk of fracture?
Model answer
Restoring oestrogen restrains osteoclast activity again, so the rate of bone resorption falls back towards the rate of deposition and bone density is maintained rather than lost.
5
Give three disadvantages or risks of hormone replacement therapy.
Model answer
Combined preparations carry a small increase in breast cancer risk that grows with duration of use, there is an increased risk of venous thrombosis and of stroke, and side effects such as breast tenderness and irregular bleeding are common.
6
Why may a skin patch be preferred to a tablet for a woman at risk of thrombosis?
Model answer
Oestrogen absorbed through the skin passes into the general circulation without first going through the liver, so it does not increase the liver's output of clotting factors in the way an oral dose does and the risk of thrombosis is much lower.

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The Development of Species: Evolution and Classification

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