Question

Menopausal women are often faced with the decision to undergo hormone replacement therapy (HRT). Discuss the need for HRT as it relates to menopause, informed decision making, and sexuality in menopausal women.

Answer 1

#. HRT ( Hormone replacement therapy ) - is used to help balance estrogen and progesterone levels in women around the time of menopause . It is used to treat many of the sign and symptoms of post menopause :-

- Decreased estrogen levels

- Hot flashes

- Sweating

- Sleep Disturbances

- Irritability

- Decreased cognitive function

- Vaginal Dryness and Genital Tract Atrophy

- Osteoporosis

- Heart disease

-Adverse lipid changes

-Vascular effects

#. The indications for hormone therapy :-

- vasomotor symptoms

- urogenital atrophy

- 2nd line treatment for refractory osteoporosis

#. HRT help with vasomotor symptoms :

- estrogen or estrogen plus progestins are highly effective for alleviation of hot flashes and night sweats

- for severe symptoms, estrogens are the most effective treatment

#. HRT help with sexual dysfunction :

- estrogen is effective for tx of vaginal dryness and atrophic changes that impede sexual function

- high dose transdermal androgen therapy has been shown in surgically menopausal women to improve sexual desire

#. HRT benefit the skin :

- systemic hormones may increase collagen content and skin thickness and reduce wrinkling in non-sun-exposed areas

- locally applied estrogen can also increase collagen content and skin thickness

#. HRT benefit the genitourinary tract :

- local applications may reduce urinary tract infections

- estrogens with or without progestins produces subjective improvements in atrophic vaginitis