Due to the presence of estrogen there is increased risk of breast,
endometrial and ovarian cancer, venous thromboembolism and stroke, but there are
decreased chances of vaginal atrophy, vasomotor instability and osteoporosis.
The use of transdermal formulations is preferred because of
decreased systemic side effects as the drug may not undergo the first pass
effect in liver, but patient’s preference is important.
- For localized (urogenital) effect: vaginal preparations are preferred having less systemic side effects.
- Without uterus: oral or non-oral estrogens without progesterone are used to avoid endometrial cancer.
- With uterus and perimenopausal: sequential HRT is used to allow a bleed.
- With uterus and postmenopausal: continuous combined HRT is used.
- High dose progestogen (medroxyprogesterone) is useful for vasomotor instability without any cardiovascular conditions.
No comments:
Post a Comment