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Menopause - Management
What issues should I discuss with a woman before starting HRT?
- Before starting hormone replacement therapy (HRT), discuss:
- The benefits and possible risks of hormone replacement therapy or tibolone (if appropriate).
- The expected duration of therapy:
- For vasomotor symptoms, most women require 2–3 years of therapy, but some women may need longer. This judgement should be made on a case-by-case basis with regular attempts to discontinue. Symptoms may recur for a short time after stopping HRT [MHRA and CHM, 2007b].
- Topical (vaginal) oestrogen may be required long term. In some women symptoms may recur once treatment has stopped [Rees and Purdie, 2006a].
- Women with premature menopause usually take hormone replacement therapy up to the age of the natural menopause (50 years); at that time, therapy is usually reassessed.
- Any possible adverse effects, such as breast tenderness or enlargement, nausea, headaches, or bleeding.
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