HRT

Question 1

What are the indications for HRT?

Answer 1

Treatment of menopause symptoms
Treatment of early menopause (until natural age of 51)
Osteoporotic fracture prophylaxi when non hormone treatments are unsuitable

Question 2

What are the contraindications to HRT?

Answer 2

Current:
-Undiagnosed PV bleeding
-Oestrogen dependent cancer
-Pregnancy
History:
-History of breast cancer
-History of VTE
-Recent stroke/angina

Question 3

What are the short term benefits of HRT?

Answer 3

Relief of vasomotor symptoms
Relief of psycological symptoms
Increased libido
Improves urogenital atrophy

Question 4

What are the risks of HRT?

Answer 4

VTE (no risk with transdermal patch)
Breast cancer (small increase in risk with combined HRT)
Ovarian cancer (if used >5 years)
Endometrial cancer if taking oestrogen only HRT

Question 5

What are the long term benefits of HRT?

Answer 5

Reduced ostroporosis

Reduced risk of coronary artery disease

Question 6

What are the side effects of HRT?

Answer 6

Oestrogen: breast tenderness, leg cramps, nausea/bloating
Progesterone: pre-menstrual syndrome
Bleeding: PV bleeding occurs towards the end of progesterone phase of cyclical HRT

Question 7

What are the types of HRT?

Answer 7

Systemic: oral or transdermal (oestrogen only or combined preperations)
Vaginal - tablet, cream, vaginal ring
Peri-menopausal - cyclical HRT - oestrogen everyday but combined with progesterone for 14 days to cause a bleed
Post menopausal - Continous combined HRT