Ovestin vaginal cream does not increase circulating oestradiol, and thus can be considered for treatment of vaginal dryness in women who’ve had breast cancer. Evidence varies on whether systemic oestrogen increases recurrence risk (HABIT trial vs. Stockholm trial) but it’s still not recommended. (BGJP Jan 2013)

Menopausal symptoms secondary to endocrine treatment tend to stabilise after about 3 months. (ibid)

I always tell patients it doesn’t matter when they take their antihypertensives (barring the obvious practicalities of diuretics). This may still very well be true, but a Cochrane review has identified a marginal advantage, in terms of BP control, in taking them in the evening rather than the morning (1.71 mmHg systolic & 1.38 diastolic on 24-hour monitoring). The clinical significance of this is as yet unknown, and I wouldn’t tell anyone to bother with taking it in the evening if they were having trouble remembering it then, but it might be worth trying for patients who are fine with remembering it either time. (ibid)


About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in BJGP, Cardiovascular, HRT, Hypertension, Medication. Bookmark the permalink.

One Response to Snippets

  1. Useful. I have for a long time suggested people divide multiple drugs between evening and morning, for HT, and felt that the early morning “aargh time to get up I’m late I’m late” surge in BP is likely to be a problem.

    Some people take their tablets when their eyes open, others seem to potter around for an hour before getting round to it, and I suppose designing a study to demonstrate that the latter have more trouble is now made more difficult by recognising they ought to tkae them on going to bed.

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