HRT.
When is HRT particularly desirable: - Premenopausal bilateral ooporectomy, hysterectomy, increased risk of osteoporosis eg: inactive or smokers, Ischaemic heart disease or risk factors like DM and hypercholesterolaemia and Rheumatoid arthritis.
Rule out thyroid and psychiatric problems before starting HRT as they present similarly.
counseling helps psychosocial problems, contraception should be continued for a year after the last period (PoP, IUCD and barrier methods are suitable).
Hot flushes and vaginal dryness respond to HRT.
HRT postpones menopausal bone loss and protects against
cardiovascular disease and ovarian carcinoma.
Women with uterus should receive oestrogen & progesterone
preparations. If bleeding - endometrial biopsy after 8 months.
SE:- weight gain, cholestasis & vomiting.
CI to HRT: - breast carcinomas, undiagnosed PV bleeding, breast feeding, h/o DVT or PE.
Types of HRT: Oral, creams, pessaries, rings, transdermal patches and oestradiol implants.
Refer: HRT Counseling.