When to start hrt
Menopause - When is HRT advisable?
on the whole HRT is really an individual
woman's choice in as much as she's got a
lot of symptoms and she or she's having
a dreadful menopause or she's got
minimal symptoms and she's sailing
through it there might be some
situations where we would actually
advise you to consider HRT and normally
you know it isn't like you've got cancer
you must have treatment it is normally
an individual woman's choice but there
might be one or two situations if you
have severe osteoporosis severe bone
loss especially at the hip HRT is better
for both buy-back than having a
bisphosphonate a mineraloid a non
hormonal approach which are better at
the spine of the hip the other non
hormonal approaches to bone protection
are not as good at the hip as they are
at the spine and the spine they do well
at the hip not so well we've got some
evidence that if you use bisphosphonates
for more than five or six years they
have their own problems to be honest so
you might recommend HRT if you've got
severe bone loss you would recommend HRT
if a woman's quality of life was really
bad and they just were struggling and
weren't coping sometimes the husband or
the family bring the woman up and say
that she's been you know nightmare to
live with she's screaming she's tearful
one minute and screaming at people the
next and she's just not coping well and
we can't cope anymore with her so it's
actually not the woman who comes up
she's brought up by the family and you
might talk that through and say well
look maybe you should have a short
period of HRT to try and overcome these
problems they might be getting such
severe sweats and flushes at night that
they're waking four or five five times a
night and then they're getting the
effects of sleep depletion and they just
can't cope because they're getting sleep
depletion so these are categories where
you might say well look your quality of
life awful you can't cope we would
recommend HRT and sometimes they're
getting terrible vagina soreness and
dryness maybe even bleeding with
intercourse intercourse is painful it
can put a strain on the relationship
it's no longer pleasant or they're
getting totally urinary symptoms and you
might work
and even if not properly Chanti tablets
or patches local for China creams and
pessaries to try and help down below um
and sometimes it's a libido issue some
of the women come to me and say I'm
having real difficulty I've got no
sexual urge at all I'm just can't cope I
don't want it I'm just getting my teeth
it's not enjoyable it's effective in
relationship so then you might need to
look at whether they need male hormone
with the HRT give you HRT first but
whether or not they need maybe some
androgen supplement as well so there
could be a libido issue or sword
soreness and dryness down there that's
affecting sex in one way or another and
so there's that category as well that
you might want to be offering something
to help
