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  • 1.HORMONE REPLACEMENT THERAPY (HRT) Evidence-based Guidelines Dr Mahdy El- MazzahyDamietta general Hospital 7 thInternational AnnualCongressAlexandria12- 2002

2. Introduction

  • HRT does not suit everyone.
  • Each woman needs to be aware of the benefits and potential risks of HRT (pros and cons) so that she can make an informed decision.
  • Our duty as clinicians is to ensure that women are provided with consistent and up-to-date information

3. HRT and Menopausal Symptoms 4. VASOMOTOR HOT FLUSHES includes night sweats

  • Grade A
  • HRT is an effective treatment for hot flushes
  • Tibolone is effective for alleviating the severity and reducing the frequency of hot flushes

N.Z Guidelines May 2001 N.Z Guidelines May 2001 5. VASOMOTOR HOT FLUSHES (includes night sweats)

  • Grade B
  • Unopposed estrogen may be effective for reducing the waking episodes that are associated with sleep disruption.
  • There is no evidence that HRT is effective for vasomotor symptoms such as headaches and dizziness .

N.Z Guidelines May 2001 6. Vaginal atrophy

  • Grade A
  • Low dose topical estrogen is an effective treatment
  • E3 (estriol) therapy is also effective but requires either the addition of progestogen or close monitoring of the endometrium
  • Tibolone has been shown to be effective for vaginal atrophy

N.Z Guidelines May 2001 7. PSYCHOLOGICAL SYMPTOMS

  • These include depression, mood changes, anxiety, irritability, loss of libido, lack of energy and memory loss.

8. PSYCHOLOGICAL SYMPTOMS

  • Grade A
  • Estrogenis not an effectivetreatment in elderly women with established Alzheimer's disease
  • The addition of low doses of androgens to HRT provides relief in women with either a premature or surgical menopause who suffer from low libido ( for

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