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Menopause - Management
How should I manage women who have had a hysterectomy with HRT?
- Offer lifestyle advice.
- Advise the woman about the risks and benefits of oestrogen-based hormone replacement therapy (HRT) and record in the notes.
- For urogenital symptoms (e.g. vaginal dryness, dyspareunia) offer low-dose vaginal oestrogen (cream, pessary, tablet, or ring) or systemic (oral or transdermal) oestrogen replacement therapy:
- Vaginal oestrogen may be preferred if the woman does not wish to take, or cannot tolerate systemic oestrogen.
- For vasomotor symptoms (e.g. hot flushes, night sweats), with or without urogenital symptoms, offer systemic (oral, or transdermal) unopposed oestrogen replacement therapy.
- Decreased libido: seek specialist advice if considering testosterone patches or implants.
In depth
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