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Menopause - Management
How should I manage post-menopausal women with HRT (intact uterus)?
- Offer lifestyle advice.
- Advise the woman about the risks and benefits of oestrogen-based hormone replacement therapy (HRT) or tibolone as appropriate 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) continuous combined HRT:
- Low-dose vaginal oestrogen may be preferred if the woman does not wish to take systemic HRT or cannot tolerate systemic HRT.
- For vasomotor symptoms (e.g. hot flushes, night sweats), with or without urogenital symptoms, offer systemic (oral or transdermal) continuous combined HRT or tibolone.
- Decreased libido: consider offering tibolone (licensed use).
- Offer advice regarding contraception: a suitable method of contraception should be used for 1 year after the last menstrual period if the woman is more than 50 years of age, or for 2 years after the last menstrual period if the woman is less than 50 years of age.
- See the CKS topic on Contraception for more information on contraception in menopausal women.
In depth
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