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Menopause - Management
What follow up is required?
- Review the woman 3 months after starting hormone replacement therapy (HRT) and once each year thereafter.
- At 3-months:
- Enquire about bleeding patterns, check blood pressure, and body weight.
- Assess the effectiveness of treatment and adjust to achieve symptom control.
- Enquire about adverse effects and manage appropriately.
- Once each year:
- Check blood pressure, effectiveness of treatment and adjust to achieve symptom control.
- Enquire about adverse effects and manage appropriately.
- Consider switching from cyclical HRT to continuous combined HRT, if appropriate.
- Interrupt treatment with intravaginal oestrogen and consider stopping systemic HRT, to re-assess the need for continued use.
- Discuss the risks and benefits of HRT. Explain that some of the risks (e.g. breast cancer, ovarian cancer) associated with HRT increase with longer duration of HRT.
- Perform a breast examination if indicated by personal or family history.
- Encourage breast awareness and participation in the national breast screening programme as appropriate for their age.
- Pelvic examination is required only if clinically indicated (e.g. if there is unscheduled bleeding, especially if heavy, prolonged, or recurrent).
In depth
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