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Menopause and HRT

With the increase in life expectancy, women in the western world now live a significant part of their lives after the menopause, a period marked by cessation of menstruation due to ovarian failure. By definition, periods need to have stopped for a year before a woman can be said to be menopausal although it may be heralded by infrequent and irregular periods and associated symptoms.

The ovaries are a major source of the hormone eostrogen and almost all associated symptoms including hot flushes, vaginal dryness, irritability, dry skin, forgetfulness, urinary symptoms, etc. can be explained by this. Other hormones such as testosterone are also decreased and contribute to the symptoms.

Loss of bone mass and furring of the arteries is amongst the serious long-term complications.

The logical treatment of replacing the deficient hormones, especially eostrogen, has become controversial in recent years due to the perceived relative risk from taking either eostrogen or its combination with progesterone. Despite the sometimes-conflicting evidence from the Women's Health Initiative study and the Million Women Study, there is a large group of women in whom symptoms are so severe as to justify treatment, where quality of life far outweighs any apparent decrease in its quantity.

Other treatments include testosterone, antidepressants, phyto-oestrogens and clonidine for hot flushes. Your GP will discuss this with you.

Further reading