Category Archives: HRT

Managing menopause

(Notes from BMJ module) From 45 yrs onwards, menopause/perimenopause can be diagnosed on history only. FSH or other blood tests are not actually helpful in diagnosis in the >40s because of the wide fluctuation in levels in the perimenopause. FSH … Continue reading

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HRT and heart disease

Well, we have an update on the days of the Million Women Study (though it’s still a cool trial name). Much of the data available then were from women starting HRT in their mid-sixties, and this skewed the data. It … Continue reading

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Who can have it? Several of the contraindications to combined oral contraception are not contraindications to HRT; in particular, being a smoker over 35 is not considered a contraindication at all, even to oral HRT. I suppose that one was … Continue reading

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HRT post MI

Surprisingly, it appears to be OK. Hulley et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA 1998; 280: 605 – 13, and follow-up Grady et al, Cardiovascular disease outcomes during … Continue reading

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Menopausal symptoms

  Lifestyle measures: Healthy diet/regular exercise/avoiding smoking/reducing alcohol, caffeine, and stress, can all help to reduce symptoms to some extent.   Therapy for hot flushes:   HRT – 77% reduction relative to placebo, plus significant reduction in symptom severity. SSRIs … Continue reading

Posted in Credits 2013, Gynaecology, HRT, Medication | 1 Comment


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 … Continue reading

Posted in BJGP, Cardiovascular, HRT, Hypertension, Medication | 1 Comment


It may be worth starting metformin immediately on diagnosis of DM, without waiting to see whether dietary treatment works. One study found that starting metformin within three months of diagnosis was associated wtih a reduced rate of monotherapy failure a … Continue reading

Posted in Alternative medicine, BMJ, Cardiovascular, Credits 2012, Dementia, Diabetes, HRT, Migraine, Paediatrics | Leave a comment