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