Information giving - HRT

Question 1

How to start consultation?

Answer 1

Ideas
Explore what the patient currently understands about HRT:

“What do you already know about HRT?”

Concerns
Ask if the patient has any concerns about HRT:

“Is there anything that worries you about HRT?”

Expectations
Explore the patient’s expectations of the consultation and HRT:
“What were you hoping HRT might be able to do for you?”

Question 2

what is HRT?

Answer 2

Hormone replacement therapy, often referred to as HRT, is an effective treatment for menopause-related symptoms. HRT can also have a positive influence on other long-term health problems associated with the menopause, such as reducing the risk of osteoporosis, cardiovascular disease and stroke. The aim of HRT is to restore the low levels of hormones that occur as a result of menopause.

Question 3

How is HRT taken?

Answer 3

There are many ways in which you can take HRT, with the most common way being tablets (oral HRT). Other forms of HRT include skin patches, gels and implants such as the Mirena coil. You can try different forms and find the ones that work best for you.

Question 4

How does HRT work?

Answer 4

he menopause occurs when your ovaries stop producing eggs. As a result of the menopause, there are reduced levels of the hormones oestrogen and progesterone in your body. This can result in symptoms such as hot flushes, weakened bones and vaginal dryness. HRT works by replacing these hormones to varying degrees with the hope of reducing the symptoms and health problems associated with menopause.”

Question 5

What are the advantage of HRT?

Answer 5

1. Reduction of vasomotor symptoms - no more hot flushes

Improved mood
HRT can improve mood and also depressive symptoms.

Improvement of urogenital symptoms ²
Various studies have shown that HRT significantly improves vaginal dryness and sexual function.

Reduces the risk of developing osteoporosis
HRT rapidly normalises turnover and preserves bone mineral density at all skeletal sites, leading to a significant reduction in vertebral and non-vertebral fractures.

Cardiovascular protection
Taking HRT can reduce the risk of cardiovascular disease.

Question 6

What are the disadvantages of HRT?

Answer 6

Oestrogen: breast tenderness, leg cramps, bloating, nausea and headaches.

Progestogen: premenstrual syndrome-like symptoms, breast tenderness, backache, depression and pelvic pain.

Bleeding: breakthrough bleeding

Question 7

Risk of HRT?

Answer 7

1. VTE
2. Ischaemic stroke
3. Breast cancer
4. Endometrial cancer

Question 8

CI to taking HRT

Answer 8

1. Current, past, or suspected breast cancer
2. Known or suspected oestrogen-sensitive cancer
3. Undiagnosed vaginal bleeding
4. Untreated endometrial hyperplasia
5. Previous idiopathic or current venous thromboembolism