What are the advantages of HRT?--

• Reduction in menopausal symptoms which are due to deprivation of estrogen.
• Reduction in osteoporosis & resultant decrease in the risk of fractures.
• Reduction by about 30% in deaths due to cardiovascular diseases.
• Some data shows reduction in the risk of colon cancer as well.

Regimens--

1) Unopposed estrogen.
2) Estrogen & cyclic progestin--In this progesterone is added on days 1-14 each month.
3) Estrogen & continuous progesterone-- In this with estrogen ;progesterone is given everyday.

Why is progesterone added?--
Addition of progesterone drastically reduces the risk of endometrial cancer.

Estrogen with continuous progesterone is much less likely to cause menstrual bleeding.

Contraindications--

History of breast cancer.
History of endometrial cancer
.Unexplained vaginal bleeding.
Acute liver disease.
Recurrent thromboembolic disease(for meaning ref to On Line Dictionary)

Side effects--

Breast tenderness
Bloating
Headache
Menstrual bleeding; but it decreases after 6 months in tretement with estrogen with continuous progesterone.

Regular evaluation---
Regular breast examination.
Annual mammography.
Prompt evaluation of any vaginal bleeding.

Selective Estrogen receptor Modulators(SERMs)--

These are the breakthrough drugs in HRT. Click here.

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