HRT is not required in all menopausal but it needs in
1)symptomatic
2)high risk cases of cardiovascular dis, osteoporosis
Alziemers disease, colonic cancr
3)as prophylaxis.
SYMPTOMATIC wmn who suffer frm vasomotor sym, urinary sym,
dyspareunia, & psychosomatic problems requires short trm betn
3_6mnth
Women wth atherosclerosis,hypertriglyceridemia,IHD may benefit frm cardioprotective effct of prophy oestrogen.
Prophy HRT may delay/prevent Alzimer dis.
OSTEOPOROSIS in this HRT is cornerstöne in prophy & treatmnt
DRUGS DOSES& ROUTE
OSTROGEN therapy short term ie
3_6 mmths oral PREMARIN 0.625mg daily & 1.25mg if necesry.
ETHINYL OSTRODIOL 0.01mg
Evalon 1_2 mg
ostradiol cream in dyspareunia urethral syndrome
LONG TERM therapy in delaying osteoporosis &cv risk
Oral OESTRADIOL larger doses
ESTRADERMAL Patch 3_4mg releases 50mmg each day.
Gel Vaginal cream,Implant also available
B)PROGETOGENS:For 10_12days in each cycle to avoid risk of Emdometrial hyperplasia ,Breast cancer.Improves Bone mineral density.
PRIMOLUT N 2.5mg
Medroxyprogesterone & Duphaston 10mg
c)OTHER DRUGS
Tibolone, Raloxifene(evista).Soya
Biphosponates.
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