Menopause and HRT

Question 1

What type of HRT can be given to a patient with irregular menstrual periods but are peri-menopausal?

Answer 1

Topical cyclical combined HRT

Question 2

When is HRT contraindicated?

Answer 2

1. Undiagnosed vaginal bleeding e.g. LMP 12 months ago but has started bleedingin the last few days
2. Current or past breast cancer
3. Any oestrogen-sensitive cancer
4. Untreated endometrial hyperplasia

Question 3

What type of HRT is used in patients with the Mirena coil?

Answer 3

Oestrogen patch
(as she already has progestogen in situ of the uterus)

Question 4

What part of combined HRT carries the biggest risk of breast cancer?

Answer 4

The progestogen content.