Menopause

Question 1

Common symptoms of Menopause?

Answer 1

Vasomotor symptoms (hot flushes and night sweats)

Psychological symptoms (sleep disturbances, low mood, anxiety, irritability, poor concentration, low libido)

Physical symptoms (Joint and muscle pain, fatigue)

Genito-urinary symptoms (vaginal dryness, dyspareunia, urinary urgency, frequency, Incontinence, recurrent urinary tract infections)

Question 2

Indications for HRT?

Answer 2

Women with Premature Ovarian Insufficiency (menopause < age 40) and Early Menopause (menopause < age 45) should be encouraged to use HRT at least until the average age of menopause (51) for cardiovascular and bone health benefits

Question 3

Why is porgestrone added to HRT?

Answer 3

Most menopausal symptoms will respond well to oestrogen

A progestogen is added to prevent the long-term adverse effects of unopposed oestrogen (endometrial hyperplasia or carcinoma) in anyone with a uterus

For women who have had a hysterectomy, HRT containing oestrogen only is required.

Question 4

Sequential Combined HRT vs. Continuous Combined HRT?

Answer 4

Question 5

Benefits of HRT?

Answer 5

Question 6

Risks of HRT?

Answer 6

Combined oestrogen and progestogen HRT can be associated with a small increased risk of breast cancer

Unopposed oestrogen is associated with an increased risk of endometrial cancer

Oral HRT increases the risk of VTE/Stroke compared to baseline population risk