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Menopause - Management
How do I manage oestrogen-related adverse effects?
- Oestrogen-related adverse effects (e.g. fluid retention, bloating, breast tenderness or enlargement, nausea, headaches, leg cramps, and dyspepsia) may occur continuously or randomly throughout the cycle.
- Advise to persist with treatment for 3 months (as adverse effects may resolve):
- Leg cramps: lifestyle changes (e.g. exercise and stretching of the calf muscles) may be helpful.
- Nausea/gastric upset: adjust the timing of the oestrogen dosage or take with food.
- Breast tenderness: low-fat, high-carbohydrate diet may be helpful.
- Migraine: transdermal therapy as this produces more stable oestrogen levels.
- For persistent adverse effects, consider:
- Reducing the dosage or
- Changing the oestrogen type (i.e. swap between the two main forms of oestrogen, that is, estradiol and conjugated oestrogens) or
- Changing the route of delivery (e.g. tablets may cause nausea, but patches and gels generally do not).
In depth
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